# CBPT Research Center, extended knowledge base (llms-full.txt)

Last updated: 2026-10-01. Summary version: https://cbpt.org/llms.txt

## Identity

The CBPT Research Center is the operational structure dedicated to promoting Cognitive Behavioral Play Therapy worldwide. It is not a national body but an international point of reference that brings clinicians, trainers and researchers together around a shared scientific standard. Its three areas of work are research (defining the research agenda of the model), publication (manuals on CBPT with a preface by Susan M. Knell) and training (online courses for mental-health professionals worldwide). Scientific direction: Maria A. Geraci and Susan M. Knell. Website: https://cbpt.org/. Course platform: https://course.cbpt.org/.

## The CBPT method

CBPT is a developmentally appropriate therapeutic intervention designed for young children (2.5 to 8 years). The child takes an active role in the process of change and mastery of their problems. It is based on cognitive and behavioral theories of emotional development and psychopathology and derives from Cognitive Therapy (Beck, 1964, 1976). Knell built on Beck, Ellis and Bandura and demonstrated that CBT can be communicated to children through play (Knell 1993, 1994, 1997, 1998, 1999; Knell & Moore 1990; Knell & Ruma 1996, 2003; Knell & Dasari 2006). Adapting CT to children modifies the methodology, not the theoretical foundation. The CBPT therapist focuses on the child's strengths, favors experiential play-based interventions over complex verbal skills, and encourages language to describe experiences and emotions. CBPT is directive: goals are defined, therapist and child choose materials together, play teaches more adaptive skills, the therapist interprets play, and praise reinforces appropriate behavior (Knell, 2009, five areas of difference from non-directive play therapy). Core techniques: modeling, role-play, positive reinforcement, self-monitoring, systematic desensitization, contingency management, bibliotherapy. Core tools: puppets (including the Puppet Sentence Completion Task for assessment), therapeutic storytelling and bibliotherapy, expressive arts, and, at the advanced level, sandtray.

### The CBPT standard protocol (five steps)

1. Assessment, engagement and case formulation: clinical assessment and play observation, parent and caregiver meetings, child-friendly case formulation with drawings, puppets or stories, observable goal setting with the family.
2. Psychoeducation and emotional literacy: normalizing and externalizing the problem (worry monster, anger volcano, bossy thoughts), emotional vocabulary, understanding the CBT model through play.
3. Skill building through play: cognitive skills (thought bubbles, comic strips, puppet dialogues), behavioral and regulation skills (breathing play, relaxation, self-talk, problem solving), graded play-based exposure and behavioral experiments, reinforcement through token systems and reward games.
4. Parent work, environment and generalization: parent guidance, home and school plans with weekly missions, monitoring charts.
5. Consolidation and relapse prevention: review of goals, relapse-prevention stories and future movies, a closing ritual (certificate, CBPT toolbox, skills booklet).
Source: https://cbpt.org/cbpt-standard-protocol/

### Clinical areas

- Selective Mutism: graded, play-based steps toward verbal communication, with stimulus fading and parent involvement. https://cbpt.org/selective-mutism-cognitive-behavioral-play-therapy/
- Specific Phobia: graded exposure and coping skills rehearsed through play. https://cbpt.org/specific-phobia-cognitive-behavioral-play-therapy/
- Oppositional Defiant Disorder: emotion regulation, problem solving and parent training. https://cbpt.org/oppositional-defiant-disorder-cognitive-behavioral-play-therapy/
- Obsessive-Compulsive Disorder: play-adapted exposure and response prevention. https://cbpt.org/obsessive-compulsive-disorder-cognitive-behavioral-play-therapy/
- ADHD: self-regulation, planning and frustration tolerance through play. https://cbpt.org/adhd-cognitive-behavioral-play-therapy/
- Generalized Anxiety Disorder: externalizing worry and tolerating uncertainty. https://cbpt.org/generalized-anxiety-disorder-cognitive-behavioral-play-therapy/
- Childhood Depression: behavioral activation and restructuring of negative self-beliefs within play. https://cbpt.org/childhood-depression-cognitive-behavioral-play-therapy/
- Childhood Anger: trigger awareness and alternative responses. https://cbpt.org/childhood-anger-cognitive-behavioral-play-therapy/
- Separation Anxiety: graded exposure, coping skills and reduction of parental accommodation. https://cbpt.org/separation-anxiety-cognitive-behavioral-play-therapy/
- Encopresis and Enuresis (elimination disorders): behavioral routines and de-shaming alongside medical care. https://cbpt.org/encopresis-enuresis-cognitive-behavioral-play-therapy/
- Neurodevelopmental disorders (CBPI-R): Cognitive Behavioral Play Intervention, Remediation: play-based neurocognitive rehabilitation. https://cbpt.org/cbpi-r-neurodevelopment/

## Team

### Susan M. Knell, Ph.D.
Pioneer of Cognitive Behavioral Play Therapy and scientific director of the CBPT Research Center. Ph.D. in Clinical Psychology from Case Western Reserve University, Master's in Developmental Psychology from Ohio State University. Author of Cognitive Behavioral Play Therapy (Jason Aronson, 1993; Italian edition 1998), the first to study the application of cognitive-behavioral therapy in young children. Clinical psychologist for more than 25 years and Adjunct Assistant Professor at Case Western Reserve University, where she supervises and teaches doctoral students. Co-founder of the CBPT Institute in Rome.
Profile: https://cbpt.org/susan-m-knell-2/

### Maria A. Geraci
CEO and Director of the CBPT Research Center, co-directs its scientific direction. Cognitive-behavioral psychotherapist (Humanitas School of Specialization, Rome, LUMSA University), university specialization in Psychological Assessment (Sapienza University of Rome), Master's in Play Therapy (International Academy of Play Therapy, Lugano), Play Therapy Practitioner (APTI). Author of La Play Therapy Cognitivo-Comportamentale (Armando Editore, 2022), Cognitive Behavioral Play Therapy: Evolution of the theoretical model and development perspectives (Armando, 2024) and Trattamento neurocognitivo nei disturbi del neurosviluppo (Armando, 2025, CBPI-R model). Contract lecturer at LUMSA University and coordinator and lecturer at the Humanitas School of Psychotherapy; 20 years as school psychologist and 12 years of developmental-age psychotherapy with CBPT.
Profile: https://cbpt.org/maria-a-geraci-2/

### Lisa Remey, MEd, LPC-S, RPT-S, NCC
CBPT faculty, sandtray. Licensed Professional Counselor Supervisor, Registered Play Therapist Supervisor and Registered Sand Therapist. Owner of the Bluebonnet Center for Play Therapy (Texas), co-editor of The Handbook of Cognitive Behavioral Play Therapy, past President of the Texas Association for Play Therapy.
Profile: https://cbpt.org/instructors/

### Ornella Argento
CBPT faculty, research protocols. Psychologist at the CBPT Research Center, where she coordinates the Scientific Research Area. Over ten years of research in psychology, neuropsychology and cognitive sciences, author of peer-reviewed publications with impact factor, coordinator of experimental clinical protocols.
Profile: https://cbpt.org/ornella-argento-2/

### Samantha Martin
CBPT faculty, school refusal. Clinical Psychology graduate student in the Department of Psychological Sciences at Case Western Reserve University, working on the application of CBPT to school refusal.
Profile: https://cbpt.org/instructors/

### Meena Dasari, Ph.D.
CBPT faculty; co-teaches CBPT Case Conceptualization with Susan M. Knell and co-author with Knell of work on CBPT.
Profile: https://cbpt.org/meena-dasari-2/

## Courses (all self-paced, online, in English, lifetime access, learning test, certificate of completion from the CBPT Research Center)

Catalog: https://cbpt.org/cognitive-behavioral-play-therapy-2/ . Certification path: https://cbpt.org/certification-in-cognitive-behavioral-play-therapy/ . Current prices are shown on each course page.

### CBPT Theoretical Pack (Package)
The complete theoretical foundation in one path — model plus case conceptualization. Better value than single courses.
https://cbpt.org/course-cbpt-theoretical-pack/

### Clinical Applications Pack (Package)
Every disorder-specific protocol in one package — selective mutism, OCD, anxiety, toileting and more. The route most clinicians choose.
https://cbpt.org/package-clinical-applications-cbpt-course/

### CBPT Tools Pack (Package)
All the CBPT tools — puppets, storytelling and expressive arts — in one package.
https://cbpt.org/tools-cognitive-behavioral-play-therapy-course/

### CBPT Basic Theoretical Model (First Level)
The cornerstone of CBPT: cognitive-behavioral principles combined with developmentally appropriate play. The model’s rationale, session structure and how play becomes a vehicle for change.
https://cbpt.org/cbpt-basic-theoretical-model-course/

### CBPT Case Conceptualization (First Level)
Turn assessment into a clear, individualised treatment plan: read the child’s play, map maintaining factors and build a formulation that guides every phase.
https://cbpt.org/cbpt-case-conceptualization-course/

### Selective Mutism (First Level)
A full CBPT protocol for children who can’t speak in specific settings: assessment, five-phase work, parent training and graded exposure through play.
https://cbpt.org/cbpt-clinical-applications-course-selective-mutism/

### Obsessive-Compulsive Disorder (First Level)
Treat childhood obsessions and compulsions with play-adapted CBT: the worry–ritual cycle, exposure and response prevention, and family involvement.
https://cbpt.org/cbpt-clinical-applications-course-ocd/

### Separation Anxiety (First Level)
Help children tolerate separation and uncertainty: graded exposure, coping skills and reducing parental accommodation.
https://cbpt.org/cbpt-clinical-applications-course-separation-anxiety/

### Anxious & Fearful Children (First Level)
Generalized anxiety, fears and specific phobias: worried self-talk, avoidance and arousal, with graded exposure through play.
https://cbpt.org/anxious-and-fearful-cbpt-clinical-applications-course/

### Toileting Issues (First Level)
Encopresis and enuresis from a CBPT perspective — behavioural routine, de-shaming and parent coaching alongside medical care.
https://cbpt.org/cbpt-clinical-applications-course-toileting-issues/

### Use of Puppets (First Level)
Puppets as a structured CBPT technique — modelling, role-play and externalisation — with practical, in-session guidance.
https://cbpt.org/use-of-puppets-cbpt-tools-course/

### Therapeutic Storytelling (First Level)
Therapeutic storytelling to externalise the problem, rehearse coping and reframe the child’s narrative within CBPT.
https://cbpt.org/use-of-therapeutic-storytelling-cbpt-tools-course/

### Expressive Arts (First Level)
Art-based, expressive techniques to reach children who express themselves better through making than words.
https://cbpt.org/use-of-expressive-arts-cbpt-tools-course/

### CBPT and Sandtray (Second Level)
Bring sandtray work into CBPT: when and how to use it, integrated with the cognitive-behavioral frame.
https://cbpt.org/cbpt-and-sandtray-second-level/

### CBPT Guidelines (Second Level)
The standards and best-practice guidelines for delivering CBPT consistently and ethically.
https://cbpt.org/cbpt-guidelines-second-level/

### Roadblocks in CBPT with Children (Second Level)
What to do when therapy stalls: navigating resistance, ruptures and common roadblocks with children.
https://cbpt.org/roadblocks-in-cbpt-second-level/

### Research Protocols in CBPT (Second Level)
Research-grade CBPT protocols for measurable, evidence-aligned practice and outcome tracking.
https://cbpt.org/research-protocols-cbpt-second-level/

### CBPT for School Refusal (Second Level)
Assess and treat school refusal with CBPT: its function, a graded return and family/school collaboration.
https://cbpt.org/cbpt-school-refusal-second-level/

### Defining the Therapeutic Approach with CBPT for Internalizing Disorders (Second Level)
Connects the DSM-5 framework for anxiety, depression and somatic presentations in young children to the core CBPT toolkit clinicians bring into session.
https://course.cbpt.org/p/defining-the-therapeutic-approach-with-cognitive-behavioral-play-therapy-for-internalizing-disorders

### Parent Training in CBPT (Second Level)
Defines the Parent Training approach within CBPT — from the underlying models to the five intervention phases — to engage parents as partners in treatment.
https://course.cbpt.org/p/parent-training-in-cbpt

### Use of Play, CBT, and CBPT in Childhood (Second Level)
Traces the theoretical foundations of CBPT, from the history of Play Therapy and CBT to key theorists and the evidence behind the combined model for children ages 3–8.
https://course.cbpt.org/courses/2999562

### Integrating CBPT & EMDR (Second Level)
Combines CBPT with EMDR to support children in processing trauma through developmentally appropriate, play-based techniques.
https://course.cbpt.org/p/integrating-cbpt-and-emdr

### History of Play Therapy and Play Therapy Models (Second Level)
A journey through the historical origins of Play Therapy and its major theoretical models.
https://course.cbpt.org/courses/2998204

### Certification requirements (Practitioner in Cognitive Behavioral Play Therapy)
At least 70 hours of training with CBPT accredited trainers (online or face-to-face lessons plus individual study); at least 10 hours of case consultation with CBPT Research Center experts (group supervision counts at a reduced rate); a passed online theory test; presentation and discussion of a videotaped therapy session. The certificate confirms participation and includes registration in the list of trained professionals; it is not an accredited CE/ECM credit and does not by itself make you a play therapist.

## Publications

- Geraci M. A. (2024). Cognitive Behavioral Play Therapy: Evolution of the theoretical model and development perspectives. Armando Editore. Update of the CBPT theoretical model; emphasizes the role of case conceptualization and a path for future research.
- Geraci M. A. (2022, new edition). La Play Therapy Cognitivo-Comportamentale. Armando Editore. Preface by Susan M. Knell. The core manual on CBPT in Italian.
- Geraci M. A. (2025). Trattamento neurocognitivo nei disturbi del neurosviluppo. Armando Editore. Introduction by Susan M. Knell. Presents CBPI-R, the play-based neurocognitive treatment model for neurodevelopmental disorders.
- Geraci M. A. (2023). Comprendere il mondo dei bambini giocando. Armando Editore. Guide for parents on play as a way to understand children and support more adaptive behavior.
- Geraci M. A. (2023). Mio figlio ha paura. Che faccio? Armando Editore. Practical guide for parents on childhood fears.
- Knell S. M. (1993). Cognitive Behavioral Play Therapy. Jason Aronson. The founding text of the model. Knell's peer-reviewed and APA-published work on CBPT (Knell 1994, 1997, 1998, 1999; Knell & Moore 1990; Knell & Ruma 1996, 2003; Knell & Dasari 2006) is listed at https://cbpt.org/publications/
- https://cbpt.org/publications/

## Frequently asked questions, by page

### CBPT Basic Theoretical Model | Foundation Course Online
https://cbpt.org/cbpt-basic-theoretical-model-course/
Q: What is Cognitive Behavioral Play Therapy (CBPT)?
A: Cognitive Behavioral Play Therapy (CBPT) is an evidence-based, structured treatment approach developed by Susan M. Knell, Ph.D. that integrates cognitive-behavioral principles with play therapy techniques, adapted to a child's developmental level.
Q: What will I learn in the CBPT Basic Theoretical Model course?
A: You will learn the conceptual foundations of CBPT: how cognitive and behavioral principles are integrated within a play-based framework, and how CBPT differs from non-directive and purely behavioral child therapy approaches.
Q: Who is the CBPT Basic Theoretical Model course for?
A: The course is designed for child psychologists, psychotherapists, counselors and other mental health professionals who work with children and want to build a solid theoretical foundation before applying CBPT in clinical practice.
Q: How long is the course and is a certificate included?
A: The course consists of 4 lessons plus a learning test, totaling about 2 hours and 22 minutes. It is self-paced and online, and includes a certificate of completion.
Q: Is CBPT an evidence-based method?
A: Yes. CBPT was developed by Susan M. Knell, Ph.D., an APA-published author, and is grounded in published, evidence-based clinical research on cognitive-behavioral and play therapy approaches.

### CBPT Case Conceptualization Course | Clinical Training
https://cbpt.org/cbpt-case-conceptualization-course/
Q: What is case conceptualization in CBPT?
A: Case conceptualization in CBPT is the process of systematically assessing a child's presenting problems using the Children's Case Conceptualization Worksheet, in order to build a structured, individualized, evidence-based treatment plan.
Q: What will I learn in the CBPT Case Conceptualization course?
A: You will learn how to gather relevant clinical information, apply the CBPT case conceptualization framework, and move from assessment to a structured treatment plan for a child client.
Q: Who teaches this course?
A: The course is taught by Susan M. Knell, Ph.D., pioneer and scientific director of CBPT, together with Meena Dasari, Ph.D., a specialist in case conceptualization and assessment for children.
Q: Who is the CBPT Case Conceptualization course for?
A: It is designed for child psychologists, psychotherapists and mental health professionals who already have a basic understanding of CBPT and want to apply it in structured clinical assessment and planning.
Q: How long is the course and is a certificate included?
A: The course includes 5 lessons plus a learning test, for a total of about 1 hour and 8 minutes. It is self-paced, online, and includes a certificate of completion.

### Separation Anxiety Treatment Course | CBPT Online Training
https://cbpt.org/cbpt-clinical-applications-course-separation-anxiety/
Q: What is Separation Anxiety Disorder in children?
A: Separation anxiety is a normal developmental stage in infants and toddlers, but when it persists beyond about 3 years of age it can become Separation Anxiety Disorder, a common presenting problem in child clinical settings that can start as early as preschool age (3-6 years).
Q: How does CBPT treat separation anxiety in children?
A: Cognitive Behavioral Play Therapy (CBPT) integrates cognitive and behavioral techniques within a play-based framework, using a structured, evidence-based protocol to help children manage separation-related fears and behaviors.
Q: What will I learn in this course?
A: This course walks through practical examples of using CBPT with children presenting Separation Anxiety Disorder, showing how to apply the assessment and treatment protocol in real clinical scenarios.
Q: Who teaches this course?
A: The course is taught by Susan M. Knell, Ph.D., the creator of Cognitive Behavioral Play Therapy and an APA-published author recognized internationally for evidence-based play therapy for children.
Q: How long is the course and is a certificate included?
A: The course includes 1 lesson plus a learning test, for a total of about 25 minutes. It is self-paced, online, and includes a certificate of completion.

### CBPT Clinical Course: OCD Treatment Through Play | CBPT
https://cbpt.org/cbpt-clinical-applications-course-ocd/
Q: How does Obsessive-Compulsive Disorder present in young children?
A: In young children, OCD often shows up through observable rituals, repetitive behaviors and intrusive fears rather than the verbalized obsessions typical of adults, which is why standard adult protocols do not transfer directly to this age group.
Q: How does CBPT treat childhood OCD?
A: CBPT integrates Exposure and Response Prevention (E/RP) within a developmentally appropriate, play-based framework, helping children gradually face feared situations while reducing compulsive responses.
Q: Who is this course for?
A: Child psychologists, psychotherapists and mental health professionals who work with children presenting obsessive-compulsive symptoms and want a structured, evidence-based clinical approach.
Q: Who teaches this course and how long does it take?
A: The course is taught by Susan M. Knell, Ph.D., creator of CBPT. It includes 1 lesson plus a learning test, for a total of about 26 minutes, and is self-paced online with a certificate of completion.

### Selective Mutism Treatment Course | CBPT Training Online
https://cbpt.org/cbpt-clinical-applications-course-selective-mutism/
Q: What is Selective Mutism?
A: Selective Mutism is an anxiety-based disorder in which a child who is capable of speaking consistently fails to speak in specific social situations. It typically begins in early childhood and can persist into adolescence if untreated.
Q: How does CBPT treat Selective Mutism?
A: CBPT uses behavioral shaping techniques delivered through play to gradually help the child build comfort speaking in the situations where they currently stay silent.
Q: Who is this course for?
A: Child psychologists, psychotherapists and mental health professionals who work with children presenting selective mutism and want a structured, evidence-based treatment approach.
Q: Who teaches this course and how long does it take?
A: The course is taught by Susan M. Knell, Ph.D., creator of CBPT. It includes 1 lesson plus a learning test, for a total of about 26 minutes, and is self-paced online with a certificate of completion.

### Toileting Issues in Children: CBPT Training Course
https://cbpt.org/cbpt-clinical-applications-course-toileting-issues/
Q: What toileting issues does this course cover?
A: The course covers enuresis (bedwetting) and encopresis (soiling), common presentations in child clinical settings that often have behavioral and emotional components alongside physical ones.
Q: How does CBPT approach toileting difficulties?
A: CBPT addresses the behavioral and emotional components of enuresis and encopresis through structured, play-based clinical techniques, alongside standard medical evaluation when appropriate.
Q: Who is this course for?
A: Child psychologists, psychotherapists and mental health professionals who work with children experiencing toileting difficulties and want an evidence-based, play-based clinical approach.
Q: Who teaches this course and how long does it take?
A: The course is taught by Susan M. Knell, Ph.D., creator of CBPT. It includes 1 lesson plus a learning test, for a total of about 48 minutes, and is self-paced online with a certificate of completion.

### Anxious & Fearful Children Course | CBPT Clinical Training
https://cbpt.org/anxious-and-fearful-cbpt-clinical-applications-course/
Q: When does childhood anxiety become clinically significant?
A: Some anxiety is a normal part of child development, but when it interferes with a child's daily functioning, school performance, or social development, it may be clinically significant and warrant treatment.
Q: How does CBPT treat anxious and fearful children?
A: CBPT uses graduated exposure within a play-based framework, helping children face feared situations step by step while building coping skills, integrated with cognitive-behavioral principles.
Q: Who is this course for?
A: Child psychologists, psychotherapists and mental health professionals who work with anxious or fearful children and want a structured, evidence-based clinical approach.
Q: Who teaches this course and how long does it take?
A: The course is taught by Susan M. Knell, Ph.D., creator of CBPT. It includes 1 lesson plus a learning test, for a total of about 46 minutes, and is self-paced online with a certificate of completion.

### Puppet Therapy Training | CBPT Tools Course Online
https://cbpt.org/use-of-puppets-cbpt-tools-course/
Q: Why are puppets used as a clinical tool in play therapy?
A: Puppets give children a safe distance to explore and express difficult thoughts and feelings, and can be used to model coping strategies, practice social skills, and work through anxiety.
Q: What will I learn in this course?
A: You will learn the evidence-based therapeutic rationale for using puppets in CBPT, along with practical techniques for modeling coping strategies and facilitating emotional expression through this tool.
Q: Who is this course for?
A: Child psychologists, psychotherapists and mental health professionals who want to add puppets as a structured clinical tool within a CBPT framework.
Q: Who teaches this course and how long does it take?
A: The course is taught by Maria A. Geraci, CBPT Tools Specialist at the CBPT Research Center. It includes 9 lessons plus a learning test, for a total of about 2 hours and 54 minutes, and is self-paced online with a certificate of completion.

### Art Therapy Certificate Online | CBPT Research Center
https://cbpt.org/use-of-expressive-arts-cbpt-tools-course/
Q: What are expressive arts in CBPT?
A: Expressive arts — including drawing, painting and creative visual expression — provide children with non-verbal channels to communicate, process and integrate difficult experiences within a structured CBPT framework.
Q: How are expressive arts used clinically in CBPT?
A: In CBPT, expressive arts are used as structured clinical tools to facilitate emotional expression and support cognitive restructuring, rather than as unstructured free art.
Q: Who is this course for?
A: Child psychologists, psychotherapists and mental health professionals who want to add expressive arts as a structured clinical tool within a CBPT framework.
Q: Who teaches this course and how long does it take?
A: The course is taught by Maria A. Geraci, CBPT Tools Specialist at the CBPT Research Center. It includes 8 lessons plus a learning test, for a total of about 2 hours and 30 minutes, and is self-paced online with a certificate of completion.

### Therapeutic Storytelling Training | CBPT Tools Course
https://cbpt.org/use-of-therapeutic-storytelling-cbpt-tools-course/
Q: What is therapeutic storytelling in CBPT?
A: Therapeutic storytelling is the clinical use of narratives, metaphors and story-based activities to engage children in therapy, allowing them to explore difficult themes at a safe distance and develop new perspectives.
Q: What will I learn in this course?
A: You will learn structured guidance on using narratives and story-based activities as a clinical tool within CBPT, to facilitate insight and behavioral change in child clients.
Q: Who is this course for?
A: Child psychologists, psychotherapists and mental health professionals who want to add therapeutic storytelling as a structured clinical tool within a CBPT framework.
Q: Who teaches this course and how long does it take?
A: The course is taught by Maria A. Geraci, CBPT Tools Specialist at the CBPT Research Center. It includes 9 lessons plus a learning test, for a total of about 2 hours and 56 minutes, and is self-paced online with a certificate of completion.

### CBPT Tools Course Package | Play Therapy Tools Online
https://cbpt.org/tools-cognitive-behavioral-play-therapy-course/
Q: What is included in the CBPT Tools Pack?
A: The CBPT Tools Pack bundles three specialized courses on therapeutic tools used in CBPT: Use of Puppets, Expressive Arts, and Therapeutic Storytelling, each with evidence-based rationale and practical clinical guidance.
Q: Who is this bundle for?
A: Clinicians who already have a CBPT foundation and want to expand their clinical toolkit with creative, play-based techniques across all three tool areas at once.
Q: Is it cheaper to buy the pack than the individual courses?
A: Yes, the CBPT Tools Pack bundles all three tool courses together at a combined price, rather than purchasing Use of Puppets, Expressive Arts, and Therapeutic Storytelling separately.
Q: Who teaches this bundle and how long does it take?
A: The bundle is taught by Maria A. Geraci, CBPT Tools Specialist at the CBPT Research Center. It totals about 8 hours and 20 minutes across the three courses plus tests, self-paced online with a certificate of completion.

### Separation Anxiety Disorder in Children | CBPT
https://cbpt.org/separation-anxiety-cognitive-behavioral-play-therapy/
Q: How is separation anxiety disorder differentiated from generalized anxiety or social anxiety in children?
A: By the focus of the fear: separation anxiety is tied specifically to separation from attachment figures, whereas generalized anxiety is free-floating across many domains and social anxiety is tied to evaluation in social or performance situations.
Q: Is play therapy evidence-aligned for separation anxiety in childhood?
A: Cognitive Behavioral Play Therapy integrates the active ingredients of CBT for anxiety - psychoeducation, cognitive restructuring, graded exposure, relaxation and reinforcement - into a developmentally appropriate, play-based delivery, targeting the cognitive, behavioural and physiological components of separation anxiety disorder, under the scientific direction of Maria A. Geraci and Susan M. Knell.
Q: What role does the family play in treatment?
A: Parent training reduces accommodation and supports graded separation practice at home. Parents follow a parallel five-phase competence-based programme, learning to reinforce independence and generalise in-session gains to everyday routines.
Q: How long does treatment typically take?
A: The structured protocol is individualised to the child's presentation and progress; sessions follow a consistent structure and parent sessions are integrated at key intervals, with a follow-up to verify that gains are maintained.
Q: What does change look like over the course of therapy?
A: Easier separations and drop-offs, reduced clinging, fewer somatic complaints, more comfortable sleep and improved functioning at school and home, as the child learns that separation is safe and manageable.

### Specific Phobia in Children: CBPT Treatment | CBPT
https://cbpt.org/specific-phobia-cognitive-behavioral-play-therapy/
Q: When does a childhood fear become a specific phobia?
A: When it is marked (intense, out of proportion to actual danger), persists for 6 months or more, is actively avoided or endured with intense distress, and impairs functioning in school, social or family domains. Transient developmental fears resolve without specialist intervention; a phobia does not, and typically entrenches further as avoidance prevents corrective learning.
Q: Why is graded exposure central to specific phobia treatment?
A: Avoidance maintains phobias: by not encountering the feared stimulus, the child never learns that the feared outcome is unlikely, so the fear association is preserved. Structured, repeated approach in a safe, playful frame allows new safety learning to override the fear association. Graded exposure — moving systematically through a fear hierarchy — is therefore the core mechanism of change in the CBPT protocol for specific phobia.
Q: How is play used with young children who cannot do formal exposure?
A: Play provides a developmentally appropriate vehicle for fear hierarchy work, symbolic rehearsal and reinforcement of approach. Therapeutic storytelling, puppets that confront the feared stimulus, drawing and role-play allow the child to approach the feared thing at a level they can tolerate, building mastery before in-vivo exposures.
Q: What is the family's role in specific phobia treatment?
A: Parents are coached to support graded exposure and stop accommodating avoidance, without coercion. The CBPT parent-training track teaches parents the skills to become active agents of change: reinforcing approach behaviour, running supervised home exposure activities and using the Playbook to carry gains into daily life.
Q: How long is specific phobia treatment in CBPT?
A: The protocol is organised across roughly 16 weeks, individually tailored to the child's fear hierarchy, phobia specifier and pace of exposure. Many specific phobias respond well to focused, graded exposure-based work under the scientific direction of Maria A. Geraci and Susan M. Knell.

### Oppositional Defiant Disorder in Children | CBPT
https://cbpt.org/oppositional-defiant-disorder-cognitive-behavioral-play-therapy/
Q: How is ODD distinguished from ADHD-related impulsivity?
A: ODD centres on defiance, anger and vindictiveness in relationships; ADHD centres on attention and impulse-regulation difficulties. They frequently co-occur and should both be assessed. A child with ADHD alone may be non-compliant because of difficulty sustaining effort or following multi-step instructions; a child with ODD actively refuses, argues and blames in a relational pattern that persists across settings and with familiar adults. When both are present, treatment should address both.
Q: Why is parent training emphasised in ODD treatment?
A: ODD is maintained by coercive interaction cycles in which child non-compliance and caregiver responses escalate each other through negative reinforcement. Changing caregiver contingency management — moving from coercive to calm, consistent, positively structured responses — is one of the most effective levers for reducing ODD symptoms and preventing escalation toward conduct problems. Parent Training CBPT provides the competence-based framework for this parallel work.
Q: What does the child-directed play work add?
A: Play-based child work builds the emotion-regulation capacity, frustration tolerance and social problem-solving skills that the child lacks — skills that cannot be acquired through instruction alone in a child with ODD, because the confrontational frame of direct teaching triggers the same defiance the therapy aims to address. The non-confrontational, child-directed play frame opens access to the very capacities the intervention needs to develop.
Q: When should conduct disorder be considered?
A: Conduct disorder should be considered when there is a pattern of violating the basic rights of others or major age-appropriate societal norms or rules — including aggression to people or animals, destruction of property, deceitfulness or theft, and serious rule violations. This represents a different, more severe trajectory than ODD. ODD can precede conduct disorder, making early intervention important; the clinician should assess for both and track whether the picture evolves.
Q: How long is treatment and how is it structured?
A: Treatment is organised across roughly 16 weeks, though duration is individualised to the child and family. It combines child play sessions and parent-training meetings in a parallel structure, with both tracks following the five-phase CBPT sequence from orientation and assessment through intervention to conclusion and follow-up. The Playbook resource supports generalisation of skills into everyday life between sessions. Follow-ups are scheduled at 3, 6, 12 and 24 months.

### Encopresis & Enuresis in Children | CBPT Treatment
https://cbpt.org/encopresis-enuresis-cognitive-behavioral-play-therapy/
Q: Why is medical assessment a prerequisite before starting CBPT?
A: Constipation with overflow incontinence, urinary tract infections and structural or neurological causes must be identified and treated before behavioural and play-based work can be effective. CBPT complements medical care rather than replacing it: the psychological and play-based components address the behavioural routine, the emotional load (shame, anxiety, motivation) and parental responses, but these interventions are built on a foundation of adequate medical management.
Q: How does CBPT add value beyond behavioural charts?
A: Behavioural charts and star charts are useful tools, but they do not address the shame, anxiety and avoidance that frequently maintain elimination difficulties once they become established. CBPT targets the emotional dimension directly — de-shaming the problem, building the child's confidence and motivation, and engaging them through play rather than through pressure or performance expectations.
Q: What is the family's role in the CBPT protocol?
A: Parents play a central role throughout the protocol. They follow a parallel competence-based training pathway in which they learn non-punitive routines, reinforcement strategies and consistent problem-solving approaches that reduce conflict around toileting at home.
Q: Are encopresis and enuresis treated the same way?
A: The CBPT framework is shared — de-shaming, scheduled routines, reinforcement systems, anxiety reduction, parent training — but the intervention is tailored to the specific subtype and the individual child's profile. Constipation management is central in encopresis. In nocturnal enuresis, sleep arousal, fluid scheduling and alarm protocols feature alongside the play-based emotional work.
Q: How long is treatment?
A: The protocol is organised across roughly 16 weeks and is individualised to the child's progress and medical status. Many children improve substantially with combined medical and behavioural care within this timeframe. The structured five-phase pathway, Playbook and follow-ups at 3, 6, 12 and 24 months provide a framework that can flex to the child's needs.

### Anger & Emotion Dysregulation in Children | CBPT
https://cbpt.org/childhood-anger-cognitive-behavioral-play-therapy/
Q: Should anger be treated as a standalone problem?
A: No. Assessment should clarify the underlying picture — whether anger features within DMDD, ODD, anxiety, ADHD or a trauma-related condition — since the formulation guides treatment. Anger itself is not a DSM-5-TR diagnosis; it is a transdiagnostic feature that requires contextualisation within the full clinical picture before intervention is planned.
Q: What is DMDD and how does it relate to anger?
A: Disruptive mood dysregulation disorder (DMDD) is a DSM-5-TR diagnosis characterised by chronic irritability and frequent severe temper outbursts with onset before age 10. It must be distinguished from ODD, in which anger is more episodic and linked to defiance, and from bipolar disorder, in which irritability is tied to mood episodes. Careful assessment is required to differentiate these presentations.
Q: How does play build emotion-regulation skills?
A: Play externalises anger — through puppets, drawing and the anger thermometer — giving the child a safe context to rehearse early-warning recognition and calming strategies, and to practise problem-solving without the real-world stakes of an actual confrontation. In CBPT, these techniques are sequenced and embedded in the structured five-phase protocol under the scientific direction of Maria A. Geraci and Susan M. Knell.
Q: What is the caregiver's role in treatment?
A: Co-regulation, consistent calm responses and reduced escalation cycles are central to treatment. Parent training is an integrated part of the CBPT protocol: parents learn to recognise trigger situations, respond consistently, reinforce adaptive child behaviours and apply extinction to maladaptive ones — so the regulation work continues outside the therapy room.
Q: How long is treatment?
A: The CBPT intervention is organised across roughly 16 weeks, individualised to the underlying formulation and the specific presenting picture. Sessions follow a consistent structure: goal review, new skill introduction, practice and homework assignment. Follow-ups at 3, 6, 12 and 24 months verify that gains are maintained.

### Selective Mutism Treatment | CBPT Clinical Training
https://cbpt.org/selective-mutism-cognitive-behavioral-play-therapy/
Q: What is the evidence base for CBPT in selective mutism?
A: Cognitive Behavioral Play Therapy applies empirically supported cognitive-behavioral techniques — modeling, shaping, graded exposure, role play and reinforcement — within a developmentally appropriate play framework, consistent with the DSM-5 conceptualisation of selective mutism as an anxiety disorder. Because the child’s communication is under their own control, the protocol’s mastery-and-control mechanism directly targets the maintaining factor. The CBPT Selective Mutism course details the protocol and its clinical rationale under the scientific direction of Maria A. Geraci and Susan M. Knell.
Q: How does the CBPT protocol structure graded exposure for a non-speaking child?
A: Exposure is delivered through play and successive approximations (shaping): the child is first reinforced for nonverbal participation, then for sounds, single words and progressively more demanding verbal exchanges, always within a low-pressure setting that preserves a sense of control. Modeling with puppets, therapeutic storytelling and role play let the child rehearse speaking before generalising to school and everyday contexts. The course walks through the in-session sequencing step by step.
Q: Which assessment tools are used before treatment?
A: The assessment phase combines parent interviews, structured observation of the child’s play, assessment of family play, parent questionnaires and a sentence-completion task with puppets, plus measures personalised by the therapist. A behavioural baseline of speaking frequency is established so change can be tracked objectively across treatment. The training provides the assessment battery and scoring guidance.
Q: How is parent and school collaboration integrated into the protocol?
A: Parents follow a parallel competence-based training pathway: they learn to reinforce adaptive behaviours, apply extinction to maladaptive ones, and run supervised play sessions, so gains generalise beyond the therapy room. Regular therapist–parent meetings monitor progress and adjust parent–child interactions, while collaboration with teachers extends the consistent, reassuring environment into the school setting.
Q: How is treatment progress measured?
A: Progress is measured against the behavioural baseline established at assessment — changes in the frequency of speaking and adaptive responses across settings — together with shared, goal-oriented targets agreed with child and family. Structured follow-ups at 3, 6, 12 and 24 months verify maintenance and guide relapse prevention.
Q: What clinical training is required to deliver the CBPT selective-mutism protocol?
A: Delivering the protocol competently requires structured training in the CBPT model: the five-phase clinical sequence, the play-adapted CBT techniques, the assessment battery and the integrated parent-training pathway. The CBPT Research Center’s Selective Mutism course, under the scientific direction of Maria A. Geraci and Susan M. Knell, provides this clinician-level training with the full in-session protocol.
Q: Is selective mutism on the autism spectrum?
A: No. Selective mutism is classified in the DSM-5-TR as an anxiety disorder and is distinct from autism spectrum disorder, where social-communication differences are pervasive across all settings and accompanied by restricted, repetitive behaviours. The two can co-occur, so careful differential assessment is essential — in selective mutism communication is age-appropriate in comfortable contexts and the silence is anxiety-driven and situation-specific. The CBPT Selective Mutism course details the assessment battery used to make this distinction.
Q: Can a child outgrow selective mutism without treatment?
A: It can occasionally improve on its own, but more often it persists and the associated anxiety can carry into adolescence and adulthood, with lasting social and academic impact. Because the silence is maintained by the child’s own control over communication, early evidence-based intervention is associated with better outcomes than a wait-and-see approach. The CBPT protocol targets that maintaining mechanism directly — the course shows how.
Q: At what age can selective mutism be diagnosed?
A: A diagnosis is usually made from around ages 3 to 5, once the failure to speak has persisted for at least one month and is not limited to the first month of school, per DSM-5-TR criteria. Onset is typically before age 5, though it is often first recognised at school entry when communication demands increase. The course covers diagnostic criteria, baseline measurement and the structured assessment phase.

### Generalized Anxiety Disorder in Children | CBPT Treatment
https://cbpt.org/generalized-anxiety-disorder-cognitive-behavioral-play-therapy/
Q: How is GAD differentiated from separation or social anxiety in children?
A: By the focus and breadth of worry: GAD is free-floating across multiple domains — school performance, health, family safety, world events — whereas separation anxiety is tied specifically to attachment figures and social anxiety is tied to evaluation in social or performance situations. When worry spans several domains and is not anchored to a single trigger, GAD is the more appropriate conceptualisation.
Q: Is play therapy evidence-aligned for childhood anxiety?
A: Cognitive Behavioral Play Therapy integrates the active ingredients of CBT for anxiety — psychoeducation, cognitive restructuring, graded exposure, relaxation and reinforcement — into a developmentally appropriate, play-based delivery. The protocol targets the cognitive (worried self-talk), behavioural (avoidance, reassurance-seeking) and physiological (arousal) components of GAD through play, consistent with the DSM-5-TR conceptualisation of the disorder.
Q: What role does the family play?
A: Parent training reduces accommodation — the excessive reassurance-giving and avoidance facilitation that maintain anxiety — and supports graded exposure at home. Parents follow a parallel five-phase competence-based programme alongside the child's therapy, learning to reinforce adaptive coping and generalise in-session gains to everyday situations.
Q: How long is treatment?
A: The structured protocol is organised across roughly 16 weeks, individualised to the child's presentation and progress. Sessions follow a consistent structure: review of the previous week, new psychoeducational content, worry-exposure practice, coping-skill rehearsal and homework. A booster session is scheduled in the months following conclusion to verify that gains are maintained.
Q: What does change look like?
A: Greater tolerance of uncertainty, reduced reassurance-seeking and avoidance, fewer somatic complaints (stomach aches, headaches), improved sleep and improved functioning at school and at home. As the child learns that worry subsides without avoidance or reassurance, and develops a reliable coping toolkit, the worry cycle weakens and daily life becomes less restricted by anticipatory anxiety.

### ADHD in Children: Symptoms & CBPT Treatment Approach | CBPT
https://cbpt.org/adhd-cognitive-behavioral-play-therapy/
Q: Does CBPT replace medication or behavioural parent training for ADHD?
A: No. CBPT complements multimodal, evidence-based care for ADHD — it does not replace medication, behavioural parent training or educational accommodations. Rather, it adds skill-building and emotional support through play, working within the child's developmental capacities to build self-regulation, frustration tolerance and planning in a low-stigma, engaging context. The CBPT approach is coordinated with the wider care plan under the scientific direction of Maria A. Geraci and Susan M. Knell.
Q: What can play-based work realistically change in a child with ADHD?
A: Play-based CBPT work can support the development of self-regulation, frustration tolerance, planning, social skills and self-esteem. It does not alter the underlying neurodevelopmental trait — the profile of ADHD itself — but it builds skills and a positive self-concept that help the child function more effectively across settings. The CBPT course details the specific techniques and in-session sequencing for each of these targets.
Q: How is the inattentive presentation engaged in play therapy?
A: The predominantly inattentive presentation is engaged through structured, motivating play that scaffolds sustained attention and self-monitoring. Rather than relying on verbal instruction alone, the therapist uses play activities designed to incrementally extend the child's attention window, build self-monitoring habits and provide immediate reinforcement for on-task behaviour. The session structure itself — with clear review, goal-setting, new content and practice — models the kind of routine that supports attention in daily life.
Q: What is the role of family and school in the CBPT approach for ADHD?
A: Consistent structure, reinforcement and accommodations are central to supporting children with ADHD. Parent training is an integral part of the CBPT protocol: parents follow a parallel five-phase pathway in which they learn to recognise triggers, apply consistent reinforcement strategies and generalise skills to everyday settings. Liaison with school, where appropriate, ensures that accommodations and behavioural strategies are coordinated across contexts.
Q: How long is CBPT treatment for ADHD?
A: Treatment is typically organised across roughly 16 weeks, individualised to the child's profile and coordinated with the wider multimodal care plan. Sessions follow a consistent structure — review, goal-setting, new content, practice and homework — that itself models the routines helpful for children with ADHD. Follow-ups are scheduled at 3, 6, 12 and 24 months to confirm that gains are maintained. The CBPT course provides the full session-by-session protocol under the scientific direction of Maria A. Geraci and Susan M. Knell.

### OCD in Children: Symptoms & CBPT Treatment | CBPT
https://cbpt.org/obsessive-compulsive-disorder-cognitive-behavioral-play-therapy/
Q: What is the evidence base for CBPT in childhood OCD?
A: Cognitive Behavioral Play Therapy applies empirically supported cognitive-behavioral techniques — psychoeducation, cognitive restructuring, modeling, reinforcement and, centrally, exposure and response prevention (ERP) — within a developmentally appropriate play framework, consistent with the DSM-5-TR conceptualisation of OCD as an obsessive-compulsive and related disorder. The protocol commonly adapts the March & Mulle (1995) structured approach across roughly 16 weeks. The CBPT OCD course details the protocol and its clinical rationale under the scientific direction of Maria A. Geraci and Susan M. Knell.
Q: Is CBT with exposure and response prevention first-line for paediatric OCD?
A: CBT incorporating exposure and response prevention is widely regarded in the clinical literature as a first-line psychological treatment for OCD in children and adolescents. CBPT delivers that ERP mechanism in a play-based, developmentally calibrated way: rather than expecting a young child to tolerate exposure verbally, the therapist builds a stimulus hierarchy and works through it with drawing, storytelling and puppet play. The course walks through how exposure targets are selected and sequenced session by session.
Q: How is exposure delivered through play with a young child?
A: Exposure is graded and embedded in play. After generating a stimulus hierarchy and teaching the child to recognise the “transition zone”, the therapist uses cartographic metaphors (externalising and “making OCD the problem”), therapeutic storytelling, drawing and puppets that face similar fears so the child can rehearse facing an intrusive thought without performing the compulsion. Each session reviews the prior week, sets exposure targets, practises relapse prevention and assigns Playbook homework, so gains generalise to home and school.
Q: Which assessment tools are used before treatment?
A: The assessment phase combines parent interviews, structured observation of the child’s play, assessment of family play, parent questionnaires and a puppet sentence-completion task, plus measures personalised by the therapist. A behavioural baseline of obsessive statements and compulsive behaviours — and tools to gauge the intensity of intrusive repetitive thoughts — is established so change can be tracked objectively across treatment. The training provides the assessment battery and scoring guidance.
Q: How is family accommodation addressed in the protocol?
A: Parents follow a parallel competence-based training pathway: they learn to reduce accommodation of rituals, to reinforce adaptive behaviours and apply extinction to maladaptive ones, and to run supervised play sessions, so gains generalise beyond the therapy room. A Playbook of weekly activities, worksheets and the treatment plan turns the family into a transitional support for ERP, while regular therapist–parent meetings and a collaborative problem-solving stance keep accommodation in check without shaming the child.
Q: What clinical training is required to deliver the CBPT OCD protocol?
A: Delivering the protocol competently requires structured training in the CBPT model: the five-phase clinical sequence, exposure and response prevention adapted through play, the assessment battery, the 16-week structured protocol and the integrated parent-training pathway. The CBPT Research Center’s OCD in Children course, under the scientific direction of Maria A. Geraci and Susan M. Knell, provides this clinician-level training with the full in-session protocol.

### Childhood Depression: Symptoms & CBPT Treatment | CBPT
https://cbpt.org/childhood-depression-cognitive-behavioral-play-therapy/
Q: Why does childhood depression present as irritability?
A: The DSM-5-TR explicitly allows irritable mood in place of depressed mood as an anchor criterion for depressive disorders in children and adolescents. In developmental terms, children who lack the verbal and emotional vocabulary to articulate internal sadness often express low mood behaviourally — through frustration, reactivity, irritability or somatic complaints. Recognising irritability as a depressive equivalent rather than a conduct or behaviour problem is clinically critical for accurate formulation and appropriate intervention.
Q: How does play-based work treat low mood?
A: CBPT addresses childhood depression through two primary mechanisms adapted into play: behavioural activation, which systematically re-engages the child with pleasurable and mastery activities that break the withdrawal–low-mood cycle, and developmentally appropriate cognitive work addressing negative self-talk and appraisals through drawing, storytelling and puppet play.
Q: How is safety handled?
A: Risk assessment and appropriate referral and coordination are integral to competent clinical care for childhood depression. Assessment of suicidal ideation, intent, plan and access to means, alongside protective factors, is part of the clinical framework. CBPT is delivered within a responsible, ethically grounded clinical context; where risk is identified, safety planning and coordination with other professionals are part of the clinical response.
Q: What is the family's role?
A: Family involvement is central to the CBPT model for childhood depression. Parents follow a parallel five-phase parent-training pathway that equips them to support behavioural activation at home, model adaptive coping, help rebuild positive daily routines, and reinforce adaptive behaviours. Periodic parent meetings run throughout assessment and treatment, and the Playbook structure ensures skills are transferred into everyday family life.
Q: How long is treatment?
A: The CBPT protocol for childhood depression is typically organised across roughly 16 weeks, though duration is individualised to the child's profile, severity, comorbidity and response. Sessions follow a consistent structure with parent sessions integrated throughout and follow-up monitoring scheduled at 3, 6, 12 and 24 months.

### CBT Techniques & Interventions for Children | CBPT
https://cbpt.org/techniques/
Q: What cognitive-behavioral techniques are used in CBPT?
A: CBPT incorporates modeling, role-playing, positive reinforcement and self-monitoring, conditioning-based interventions (such as systematic desensitization and contingency management), and bibliotherapy, all adapted into a play-based format.
Q: Why are behavioral and cognitive approaches combined in CBPT?
A: Behavioral interventions reinforce adaptive behaviors, while the cognitive component gives the child an active role and sense of mastery in the process of change; combining the two matches how children develop the capacity for control and responsibility.
Q: What is modeling in CBPT and why does it matter?
A: Modeling means a toy, book, film or the therapist demonstrates the behavior the child is meant to learn — it is considered a fundamental component of most cognitive-behavioral interventions with children.
Q: Who can learn these techniques in more depth?
A: Child psychologists, psychotherapists and mental health professionals can go deeper through the CBPT training courses, which apply these core techniques to specific clinical presentations.

### Puppets in CBPT | A Cognitive Behavioral Play Therapy Tool
https://cbpt.org/puppets-2/
Q: What is the Puppet Sentence Completion Task?
A: The Puppet Sentence Completion Task, developed by Susan M. Knell, is a CBPT assessment technique that uses puppets to help young children complete open-ended sentences, revealing thoughts and feelings they may not yet be able to express verbally.
Q: Why are puppets effective with young children in therapy?
A: Puppets let a child project feelings and interpersonal conflicts into play rather than claiming difficult experiences directly as their own, making it easier to communicate distress and rehearse new, more adaptive behaviors.
Q: How does a therapist use puppets in CBPT sessions?
A: The therapist uses puppets to model coping strategies, conduct puppet interviews to understand the child and family, and create corrective emotional experiences in response to the child's play.
Q: Is there a course to learn puppet techniques in CBPT?
A: Yes, a dedicated CBPT Tools course on the Use of Puppets teaches these assessment and intervention techniques in depth for clinical practice.

### Expressive Arts in CBPT | Creative Tools for Play Therapy
https://cbpt.org/expressive-arts/
Q: What materials are used in expressive arts within CBPT?
A: CBPT uses both structured materials (pencils, markers) to support verbal tasks and represent thoughts, and less structured materials (clay, watercolors, collage) to support physical, sensory tasks such as relaxation and deep breathing.
Q: Why use expressive arts instead of just talking with a child?
A: Children often have limited verbal skills to describe abstract or complex feelings; creating art gives them a less threatening, non-verbal way to express, explore and modulate emotions that words alone cannot reach.
Q: What is the evidence base for expressive arts in child therapy?
A: Research suggests that because images are central to cognition, drawing and other visual means can give shape to internal thoughts, facilitate a child's verbal account of emotionally laden events, and support problem-solving (Malchiodi, 2003; Rosal, 2001; Hinz, 2006).
Q: Is there a course to learn expressive arts techniques in CBPT?
A: Yes, a dedicated CBPT Tools course on the Use of Expressive Arts teaches how to integrate these techniques into clinical practice with children.

### Therapeutic Storytelling in CBPT | A Tool of the Method
https://cbpt.org/the-storytelling/
Q: What is therapeutic storytelling in CBPT?
A: In Cognitive Behavioral Play Therapy, therapeutic storytelling is a structured technique that uses stories, metaphor and bibliotherapy so a child can look at a difficult experience from a safe distance. The story creates psychological space around a threatening theme and lets the child imagine and try out a more adaptive ending.
Q: Why do stories work with children in therapy?
A: Narrative is how children make sense of the world. Fables, metaphors and shared stories let a child express thoughts and feelings indirectly, without having to name what is too hard to say out loud. Identification with a character can then become a corrective experience.
Q: How does the therapist use a story in a CBPT session?
A: Storytelling in CBPT is co-constructed. By re-narrating the child's own story, the therapist models problem solving, lateral thinking, behavioral experiments and self-affirmations, while the child remains the protagonist of the change. The story is chosen to support hypothesis testing and the rehearsal of new coping strategies.
Q: What is bibliotherapy and how does it fit in?
A: Bibliotherapy applies the same logic with carefully selected published texts. A book that mirrors the child's difficulty allows emotional and behavioral issues to be addressed at a safe remove, within the cognitive-behavioral frame of the session.
Q: Is there a course on therapeutic storytelling?
A: Yes. The CBPT Research Center offers a dedicated online course on the use of therapeutic storytelling, covering narrative thinking by age, how to build therapeutic stories and the choice of texts for bibliotherapy. It is one of the three CBPT tools courses, alongside puppets and expressive arts.

### Play Therapy: Definition & Approaches | CBPT
https://cbpt.org/play-therapy/
Q: What is play therapy?
A: Play therapy is the strategic use of play within a therapeutic context to help a child express and process thoughts, needs and feelings. Play has long been recognized as a means of communication with the child and a foundation for the therapeutic relationship.
Q: What is the difference between directive and non-directive play therapy?
A: In directive play therapy the therapist defines therapeutic goals and guides the child's play toward them. In non-directive play therapy, such as Axline's Child-Centered Play Therapy, the child chooses materials and activities and the therapist communicates full acceptance without interpreting the play. Knell (2009) compares the two along five areas: goals, materials, the educational value of play, interpretation and the role of praise.
Q: Is Cognitive Behavioral Play Therapy directive or non-directive?
A: CBPT belongs to the directive approaches. Goals are set with the family, therapist and child choose play materials together, play is used to teach more adaptive skills, the therapist interprets play to help the child discuss conflicts, and praise is used to reinforce appropriate behavior.
Q: What does research say about the effectiveness of play therapy?
A: Reviews and meta-analyses (Bratton and Ray 2000, LeBlanc and Ritchie 2001, Reddy et al. 2005, Drewes 2006, Ray and Bratton 2010) support play therapy across a wide range of social, emotional, behavioral and learning problems, including anxiety, depression, ADHD, aggression and low self-esteem, and with diverse populations such as children facing chronic illness, grief, abuse or divorce.
Q: Where does CBPT come from?
A: Play therapy historically grew out of psychodynamic and client-centered theories. Cognitive Behavioral Play Therapy, developed by Susan M. Knell, keeps the positive therapeutic relationship and the use of play as communication, but adds the structure and goals of cognitive behavioral therapy.

### The CBPT Standard Protocol | Structured, Evidence-Based
https://cbpt.org/cbpt-standard-protocol/
Q: What is the CBPT standard protocol?
A: It is the structured, replicable sequence that organizes every course of Cognitive Behavioral Play Therapy: five steps from assessment to relapse prevention. The same backbone is used across different childhood difficulties, while the content of each step adapts to the specific child and presentation.
Q: What are the five steps of the CBPT protocol?
A: 1) Assessment, engagement and case formulation; 2) psychoeducation and emotional literacy; 3) skill building through play; 4) parent work, environment and generalization; 5) consolidation and relapse prevention. Each step has defined activities, from play observation and goal setting to home and school plans and a closing ritual.
Q: How are parents involved in the CBPT protocol?
A: Parents and caregivers take part from the first step, with meetings on developmental history and family patterns, and later receive the formulation and skills so they can respond consistently at home. Weekly home missions, monitoring charts and, when needed, teacher involvement help the child use new skills outside the session.
Q: Which childhood disorders does the standard protocol apply to?
A: The five steps stay the same while the content changes: ADHD, childhood depression, anger and irritability, elimination disorders, generalized anxiety, OCD, oppositional defiant disorder, selective mutism and specific phobia each have a tailored version of the protocol on cbpt.org.
Q: Where can a clinician learn to apply the protocol?
A: The CBPT Research Center teaches the full protocol in its online training, under the scientific direction of Susan M. Knell and Maria A. Geraci, with courses on the theoretical model, case conceptualization, disorder-specific clinical applications and the play-based tools.

### Certification in Cognitive Behavioral Play Therapy | CBPT
https://cbpt.org/certification-in-cognitive-behavioral-play-therapy/
Q: What is the Certification in Cognitive Behavioral Play Therapy?
A: It is a self-paced online training path offered by the CBPT Research Center under the scientific direction of Maria A. Geraci and Susan M. Knell. It moves from the theoretical foundations of CBPT to its clinical applications and tools, and ends with a certificate of participation as Practitioner in Cognitive Behavioral Play Therapy.
Q: What are the requirements to become a CBPT Practitioner?
A: At least 70 hours of training with CBPT accredited trainers (online or face-to-face lessons plus individual study), at least 10 hours of case consultation with CBPT Research Center experts (group supervision counts at a reduced rate), a passed online theory test, and the presentation and discussion of a videotaped therapy session.
Q: How is the training organized?
A: In two cumulative levels. The First Level covers the theoretical roots of CBPT, its clinical applications and the core tools (puppets, therapeutic storytelling, expressive arts). The Second Level deepens clinical work with specialized applications and advanced practice.
Q: Who is the certification for?
A: Qualified mental-health professionals who work with children: psychologists, psychotherapists, clinical counselors, psychiatrists and allied clinicians, as well as teams and centers that want to train their staff in the method.
Q: Does the certificate carry continuing education credits?
A: No. The certificate confirms participation in the CBPT training path and includes free registration in the list of trained professionals on the institutional website. It is not an accredited CE or ECM credit, and it does not by itself make you a play therapist.

### CBPT TOOLS | Cognitive Behavioral Play Therapy | CBPT
https://cbpt.org/tools/
Q: What are the tools of Cognitive Behavioral Play Therapy?
A: CBPT adapts cognitive-behavioral techniques into play through three main tools: puppets, therapeutic storytelling and expressive arts. Each one lets the child explore, express and change in a language that fits their developmental level.
Q: How are puppets used in CBPT?
A: Puppets create an atmosphere of free expression: the child projects thoughts and feelings onto the character and can say what words alone cannot. They are used for assessment with the Puppet Sentence Completion Task (PSCT), for interviewing children and families, and for modeling and role-play of cognitive-behavioral techniques.
Q: What role does storytelling play in CBPT?
A: Narrative is how children make sense of the world. In CBPT the child becomes the active author of their own improvement: the therapist works on the development of narrative thinking, builds therapeutic stories and uses bibliotherapy with carefully chosen texts.
Q: How do expressive arts fit into a cognitive-behavioral approach?
A: Creative activities give shape to emotions that have no words yet. In CBPT they are organized within the therapeutic setting and combined with cognitive-behavioral techniques, moving from art therapy in CBT to structured CBPT practice along the therapeutic path.
Q: Can I train in the CBPT tools?
A: Yes. The CBPT Research Center offers a dedicated online course for each tool (puppets, storytelling, expressive arts) and a CBPT Tools Pack that bundles all three, with practical technique you can use in session. A free ebook on the method is also available as a starting point.

### CBPI-R: Cognitive Behavioral Play Intervention – Remediation | CBPT
https://cbpt.org/cbpi-r-neurodevelopment/
Q: What is CBPI-R?
A: CBPI-R (Cognitive Behavioral Play Intervention, Remediation) is a neurocognitive treatment model for neurodevelopmental disorders developed by Maria A. Geraci and collaborators. It combines structured play activities with cognitive and behavioral techniques to improve engagement and learning skills, especially in children who resist traditional treatments.
Q: Which difficulties does CBPI-R address?
A: Underlying cognitive processes, attention and ADHD, communication disorders, specific reading and writing difficulties, and difficulties in calculation and movement. Activities are guided by the clinician and oriented to habilitative and rehabilitative goals.
Q: How is a CBPI-R session structured?
A: Five phases: a welcome phase to build adherence, potentiation of the target ability in motivating contexts, cognitive-behavioral techniques, a review with child and parents, and homework to generalize the skill outside the session.
Q: How is CBPI-R different from CBPT?
A: CBPT is a psychotherapy model for emotional and behavioral difficulties; CBPI-R applies the same play-based, cognitive-behavioral logic to the rehabilitation of neurodevelopmental disorders, with a focus on cognitive and learning abilities and on collaboration between families and clinicians.
Q: Where is the CBPI-R model published?
A: The model is presented in the manual Trattamento neurocognitivo nei disturbi del neurosviluppo (Armando, 2025), with an introduction by Susan M. Knell, as part of the CBPT Research Center's work of documenting the method.

### CBPT Online Courses & Certification | Susan M. Knell
https://cbpt.org/cognitive-behavioral-play-therapy-2/
Q: Do I receive a certificate?
A: Yes — each course includes a certificate of completion attesting your CBPT training.
Q: How long do I have access?
A: Lifetime access: you can revisit any course you enrol in whenever you like.
Q: Can I pay in instalments?
A: Yes — flexible “Pay later” options are available at checkout for most courses and packages.
Q: Do I need prior CBPT experience?
A: No. Start with the Foundational courses; the training is designed for mental-health professionals at any stage.
Q: What language are the courses in?
A: English. Selected courses are also available in other languages.
Q: I’m not sure which course is right for me.
A: Ask Dr. Lulu, our assistant — she accompanies you to the best path for your goals and clients.

### CBPT Clinical Applications Package | Online Training
https://cbpt.org/package-clinical-applications-cbpt-course/
Q: What is included in the CBPT Clinical Applications Pack?
A: Five certified courses taught by Susan M. Knell, Ph.D.: Separation Anxiety, OCD in children, Anxious and Fearful Kids, Selective Mutism and Toileting Issues. Together they total about 3 hours of video plus a learning test for each course.
Q: What will I be able to do after this bundle?
A: Distinguish which CBPT protocol fits which presentation, adapt exposure and behavioral interventions to each one (play-based E/RP for OCD, graduated exposure for anxiety, stimulus fading and puppet modeling for selective mutism, a behavioral-play dual track for toileting), and involve parents in a way that matches each problem.
Q: Who is this bundle for?
A: Clinicians who work with anxious children and want to broaden their evidence-based repertoire: psychiatrists, psychologists, clinical social workers, licensed professional counselors and licensed marriage and family therapists. The certificate of attestation is issued after verification of these requirements.
Q: How much does the pack cost compared with the single courses?
A: The pack costs $100 plus VAT, against $200 if the five courses were bought separately. A pay-later option is available at checkout and the purchase is covered by a 30-day money-back guarantee.
Q: What kind of certificate do I receive?
A: A certificate of attestation issued by the CBPT Research Center, with lifetime access to the material. It documents the training completed; it is not a continuing education credit.

### CBPT for School Refusal — Advanced Course | Samantha Martin
https://cbpt.org/cbpt-school-refusal-second-level/
Q: What does the CBPT for School Refusal course cover?
A: How to recognize the profiles of school refusal and tell them apart from truancy, how to assess the function of the refusal, when CBPT is the right fit, and how to apply psychoeducation, coping skills and exposure hierarchies so the child can gradually return to school. Adaptations for older children and adolescents are included.
Q: Who teaches the course?
A: Samantha Martin, a Clinical Psychology graduate student in the Department of Psychological Sciences at Case Western Reserve University who works on the application of CBPT to school refusal, under the scientific direction of Susan M. Knell.
Q: How are parents and schools involved?
A: The course shows how to work with parents through PRIDE skills and how to collaborate with educators, so that gains made in the playroom carry over to mornings at home and to the school day.
Q: How long is the course and what does it include?
A: Two lessons (57 and 42 minutes) plus a learning test, for a total of 1 hour 39 minutes. The course is self-paced with lifetime access, costs $99 plus VAT, and includes a certificate of attestation issued by the CBPT Research Center.
Q: Which playful tools are used to externalize anxiety in school refusal?
A: The CBT triangle, the worry monster and thought bubbles, used to help the child see the link between situations, thoughts, feelings and behavior and to talk about the fear from a safe distance.

### CBPT and Sandtray — Advanced Course | Lisa Remey
https://cbpt.org/cbpt-and-sandtray-second-level/
Q: What is Sandtray Therapy?
A: An expressive, symbolic modality that uses a standardized tray partially filled with sand and a curated selection of miniatures to help children and adolescents express thoughts and emotions without words. It originates from Margaret Lowenfeld's World Technique and balances non-directed trays with directed interventions.
Q: How is sandtray integrated with CBPT?
A: The tactile, bounded space of the tray creates therapeutic distance and symbolic exploration; within the CBPT framework, observation, tracking and processing techniques are used to reinforce coping strategies and generalize skills across contexts.
Q: What will I learn in this course?
A: The historical roots and theoretical foundations of Sandtray Therapy, its core principles (nonverbal expression, symbolic containment, therapeutic distance), how to match tray type to the child's age and stage, and how to apply non-directed and directed interventions with preschool and school-age clients.
Q: Who teaches CBPT and Sandtray?
A: Lisa Remey, MEd, LPC-S, RPT-S, NCC, Licensed Professional Counselor Supervisor, Registered Play Therapist Supervisor and Registered Sand Therapist, owner of the Bluebonnet Center for Play Therapy in Texas, co-editor of The Handbook of Cognitive Behavioral Play Therapy and past President of the Texas Association for Play Therapy. The course runs under Susan M. Knell's scientific direction.
Q: How long is the course and what does it cost?
A: Two lessons (54 and 60 minutes) plus a learning test, for 1 hour 54 minutes in total. It is a Second Level course, self-paced with lifetime access, priced at $99 plus VAT with a certificate of attestation from the CBPT Research Center.

### Roadblocks in CBPT with Children — Advanced | Susan M. Knell
https://cbpt.org/roadblocks-in-cbpt-second-level/
Q: What are the roadblocks in CBPT with children?
A: Common obstacles such as a shy child who will not let go of a parent's hand, non-compliance, aggression or refusal, nonverbal or minimally verbal children, and situations where the child's story does not match what the adults report. The course also addresses confidentiality with caregivers and prioritizing interventions when several diagnoses or parental mental-health difficulties are present.
Q: How does the course teach clinicians to handle resistance?
A: Through real scenarios: shaping strategies to build engagement before treatment, limits, reinforcement and planned ignoring for non-compliance, scaffolding of verbal expression for children who speak little, and predictability and relationship-building to encourage imaginative play.
Q: Who teaches Roadblocks in CBPT?
A: Susan M. Knell, Ph.D., clinical psychologist and adjunct assistant professor at Case Western Reserve University, author of Cognitive Behavioral Play Therapy (1993) and co-founder of the CBPT Institute in Rome. She developed the CBPT method.
Q: Does the course cover online delivery of CBPT?
A: Yes. One of the objectives is adapting CBPT for virtual delivery, alongside promoting generalization of coping skills to home and school.
Q: How long is the course and what does it cost?
A: One lesson of 62 minutes plus a learning test. It is a Second Level course, self-paced with lifetime access, priced at $50 plus VAT, with a certificate of attestation issued by the CBPT Research Center after verification of professional requirements.

### Research Protocols in CBPT — Advanced | Ornella Argento
https://cbpt.org/research-protocols-cbpt-second-level/
Q: What is the Research Protocols in CBPT course about?
A: How rigorous research and clinical practice meet in Cognitive Behavioral Play Therapy. It starts from the historical and ethical foundations of psychotherapy research, then examines why and how treatment effects are studied in children, comparing randomized clinical trials with case reports, case series, systematic reviews and meta-analyses.
Q: What makes research on child psychotherapy difficult?
A: Developmental variability, therapist effects, blinding, accessibility and ethics. The course identifies these methodological challenges in CBPT studies and shows how to translate them into feasible, ethically sound study designs for public and private clinical settings.
Q: Will I learn to design a study in my own clinical setting?
A: Yes. Objectives include designing a feasible research protocol, selecting valid and age-appropriate outcome measures and monitoring strategies, and using case reports and small-scale studies to plan pilot projects.
Q: Who teaches the course?
A: Ornella Argento, psychologist at the CBPT Research Center, where she coordinates the Scientific Research Area. She has over ten years of research in psychology, neuropsychology and cognitive sciences, peer-reviewed publications with impact factor, and experience coordinating experimental clinical protocols. The course runs under Susan M. Knell's scientific direction.
Q: How long is the course and what does it cost?
A: Three lessons (55, 49 and 64 minutes) plus a learning test, for 2 hours 48 minutes in total. It is a Second Level course, self-paced with lifetime access, priced at $99 plus VAT, with a certificate of attestation from the CBPT Research Center.