False Allegations of Sexual Abuse and The Persuasiveness of Play Therapy

Terence W. Campbell¹

ABSTRACT: A review of the social psychological literature related to interpersonal influence and attitude change demonstrates the powerful persuasiveness of play therapy.  Play therapy can capitalize on the anxiety of children and reality influence them via the therapist's reputation as a credible source.  lay therapists too often maximize their influence by isolating children from significant sources of social support thereby controlling the information available to them.  The frequent counterproductiveness of play therapy — especially in circumstances of false allegations of sexual abuse — warrants massive malpractice litigation.

Though dwarfed by the dimensions of the witness stand surrounding her, 9-year-old Rachel commands hushed silence from the entire courtroom in which she testifies.  A jury, three attorneys, and a judge all listen attentively as she graphically details the repeated episodes of sexual abuse she supposedly suffered at the hands of her mother and stepfather.  Reactions of shock and sympathy flash across the face of every juror as Rachel recalls the experiences of fellatio and vaginal penetration she apparently endured.

Dramatic and compelling as Rachel's narration of her alleged nightmare was, her testimony also evoked images of an iceberg — remembering that only one-seventh of an iceberg is visible while the rest remains submerged beneath the surface of the water.  The jury in this criminal case also understood that many issues underlying Rachel's sordid revelations demanded closer scrutiny — because after a trial of 11 days, they returned verdicts of not guilty in response to all the charges against her mother and stepfather.

Background and Chronology

Subsequent to her parents separating in September of 1986, Rachel's father became increasingly suspicious that she had been sexually abused by Mark — the man with whom his estranged wife was living.  As a result of his suspicions, Daniel (Rachel's father) sought a physical examination for suspected abuse of his then 5-year-old daughter in August of 1987.  Despite the fact that the initial examination was negative, Daniel obtained another examination for Rachel in September of 1987 which also resulted in a negative finding.  In mid-September of 1987, Daniel obtained Rachel's custody; and by mid-October of that year, he had solicited the counseling services of a Master's level psychologist (Ms. England) for Rachel.

Over the course of 13 treatment sessions between October of 1987 and February of 1988, Rachel never disclosed any report of sexual abuse to Ms. England.  Nevertheless, she reported feeling overwhelmed by the simultaneous demands for her loyalty from each of her parents.  Rachel described her ensuing conflicts in somatic terms explaining, "My stomach hurts when I feel a pull from both sides."  She moreover clarified, "The hurt starts when I see Mommy and Daddy fight," and she wistfully exclaimed, "I just wish they would stop."  As so many other children of divorce, Rachel lamented that she could not choose which parent she most wanted to live with because she still preferred to remain with both of them.

In early July of 1988, Rachel's mother (Cindy) and Mark married.  By mid-July of 1988, David had filed a formal complaint with Children's Protective Services (CPS) alleging that Mark had struck Rachel so hard that he left a hand print on her back.  CPS undertook a comprehensive investigation, found no cause for substantiation after interviewing both Cindy and Mark, and the primary investigator closed this matter observing that her agency would likely encounter this family again because of their ongoing custody dispute.  Subsequent events verified the investigator's prediction; CPS conducted another investigation related to allegations of Rachel's sexual abuse beginning in mid-August of 1988.  Like the previous investigation, this inquiry also discovered no basis for substantiation.  The second investigator also issued an ominous warning — the frequency with which Rachel was undergoing interviews regarding alleged abuse threatened the reliability of anything she might disclose in the future because of rehearsal effects.

Effects of Play Therapy

By September of 1988, Daniel had met Kathy — a divorced, psychiatric nurse — who struck him as particularly sensitive to his assessment of Rachel's problems because she had been sexually abused herself as a child.  Kathy recommended play therapy for Rachel with a Ph.D. psychologist — Dr. McKay — at the facility where she worked.  Approximately one month after initiating this course of treatment, Dr. McKay's notes indicated Rachel reporting that Mark had sexually abused her.  Rachel's recall of this apparent abuse included her description of how "Mark squirted sticky stuff on my face from his thing."  In response to the report and recommendations of Dr. McKay, the court terminated Cindy's visitation except for supervised visits confined to her former husband's residence.

In February of 1990, Dr. Will — a child psychiatrist employed at the same facility as Dr. McKay — assumed the responsibility for Rachel's treatment.  Dr. Will also advocated expressive play therapy for Rachel confident that such procedures facilitated necessary "disclosure work."  Over the next two years of treatment with Dr. Will Rachel's disclosures grew at an exponential rate; in fact, she eventually implicated her mother as participating with Mark in sexually abusing her.

In response to Dr. Will's encouragement, Rachel kept diaries of her thoughts and feelings.  Between May 1, 1990 and February 2, 1992, she made 246 separate entries in her diaries.  Rachel described her mother negatively on 121 occasions, and Mark was described negatively in 120 entries.  Her portrayals of her mother and Mark involved increasing anger and fantasized retribution, and in turn, Dr. Will praised Rachel for ventilating her feelings.  The frequency of Rachel's cathartic experiences finally led her to the conclusion that referring to her mother as "Cindy" — not as "Mom" — would afford her enormous relief and comfort.  Rachel decided to reserve the designation "Mom" for Kathy, and Dr. Will endorsed her decision — even though she had met Cindy only briefly on one occasion after which she refused her any future appointments.

To belabor the obvious, the sequence of events outlined in this case stagger the imagination.  At 5 years of age shortly after her father assumed her custody — Rachel reported the kinds of loyalty conflicts which often inundate children of divorce.  Three years later, after residing continuously in her father's custody, Rachel insists that she endured frequent sexual abuse at the age of 5 which was so cruel that it bordered on the sadistic.

Rachel's profound revision of her own history underscores the powerful persuasiveness of play therapy.  Understanding the events that transpired over the course of Rachel's treatment necessitates a review of the social psychological literature related to persuasion and attitude change.

Zimbardo, Ebbesen, and Maslach (1977) have outlined the conditions which enhance the persuasiveness of any agent attempting to influence a target subject.  Attempts at exercising influence are most effective when (1) the target struggles with persistent feelings of conflict; (2) the target's feelings of conflict provoke heightened experiences of fear and anxiety; (3) the agent(s) of influence enjoy substantial source credibility; (4) the source credibility of the influence agent(s) enhances the persuasiveness of his/her communications; (5) the target finds herself surrounded by a social network that endorses the agent(s) of influence; (6) the target's attempts at resisting influence lead to feelings of guilt; (7) the target is isolated from previously available sources of social support; (8) the agent(s) of influence effectively controls the information available to the target.

Feelings of Conflict and Anxiety

The circumstances of her parents' divorce proceeding obviously subjected Rachel to considerable duress.  In behavioral terms, she struggled with a double approach-avoidance conflict.  Her feelings of affection and loyalty for both her parents elicited approach responses in relation to each of them.  Nevertheless, sustained closeness with either parent also aroused Rachel's anxiety — and corresponding avoidance responses as she anticipated censure from the other parent.  When conflicts such as these assume chronic proportions, the child endures a painfully aversive situation that motivates attempts to escape these circumstances.  A therapist who responds sympathetically to such a child's plight, and offers hope for alleviating it, profoundly increases her influence with that child.

Source Credibility and Persuasiveness

In a manner similar to client-centered therapy, play therapy is child-centered; it encourages children to initiate whatever activity they find appealing while the therapist appears to follow the child's lead.  Children of divorce who routinely encounter indoctrination attempts regarding what they should think and feel can find short-term relief in the relatively permissive atmosphere of a play room.  Rather than immediately assassinate the character of either parent, play therapists initially seek a warm and understanding relationship with their clients that allows them to assume a role of central significance in a child's life.

When Dr. Will testified in the criminal trial on behalf of the prosecution, she disclosed how play therapists think about their endeavors:

In the early part of therapy, I was getting to know Rachel and she was getting to know me and trust me.  We worked on identifying feelings, and I let her guide where we went.  It was done initially with playing, drawing, a fairly unstructured kind of therapy.

The effusive confidence with which Dr. Will described her work was almost inspiring.  Of course, Dr. Will could only rely on self-inspired confidence for her credibility given the dismal state of play therapy outcome research (Campbell, 1992).

Unlike frustrated parents who demand what their children should do in relation to the other parent, play therapists initially confine their comments to why a child responds in various ways during treatment sessions.  For the child, then, the therapist emerges as a kindly, trustworthy figure who merely wants to understand the reasons for the child's behavior.  Compared to combative parents who rarely conceal their ulterior motives, the warm and gentle play therapist seems a paragon of virtue and fairness.  As a result, the compassionate demeanor of play therapists inspires the trust of their clients and affords them substantial credibility and influence as they interact with children.

Ultimately, however, the benign appearance of play therapists is deceptive.  Play therapy can subtly coerce children as indirectly and effectively as Rogerian techniques influence adult clients (Truax, 1966).  Like any other psychotherapy orientation, the direction of play therapy responds to the theoretical convictions of its practitioners — and play therapists endorse a tension-reduction model that enthusiastically embraces catharsis.  Consequently, play therapists attend selectively to their clients' behavior reserving their greatest interest for responses emotionally intense enough to qualify as anger.

As a result of their therapist's selective reinforcement, children in play therapy learn when they are expressing angry feelings" how significant such expressions supposedly are.  In fact, Dr. Will frequently reassured Rachel "that the feeling of anger was okay."  Thus, play therapy encourages children to actively express themselves as a necessary condition of treatment.  To the degree that children demonstrate imaginative improvisation in play therapy, they typically encounter lavish praise for the creativity with which they ventilate their feelings.  Interestingly enough, related data have demonstrated that improvised, active role playing effectively influences alterations in attitudes and beliefs.

Enhanced Persuasiveness

King and Janis (1956) assessed the degree to which making a presentation shifted the presenter's attitudes in direction of the presentation.  College students were asked to argue that 90% of college graduates would soon be drafted immediately after their graduation, and then serve a mandatory three years of military service.  The students were assigned to one of three experimental conditions: (1) subjects used an outline to improvise a speech which was tape recorded; (2) subjects read a prepared speech into a tape recorder; (3) subjects merely read the prepared speech to themselves.  The subjects who could actively improvise (Condition #1) exhibited the greatest attitude change in the direction of the speech they made.

Like the college students in the above experiment, children in play therapy respond to their treatment in an "as if" manner.  In response to the reinforcement of the therapist, they act as if they are angry; and active role playing can influence children to conclude that they are in fact angry.  Bem's (1972) self-perception theory accounts for such outcomes by emphasizing that we often infer what we believe from our most recent actions.  Considerations such as these, however, certainly did not constrain Dr. Will's imaginative interpretations.  She blithely disregarded her own influence when she described Rachel as "expressing alot (sic) of anger toward Mark and talked about hating him, wanting to tear him and poke him, and wished that he was dead."  Unless children in these circumstances define themselves as angry, they must contend with why they are acting in a manner that is so dissonant with what they think and feel.

Children who act as if they are angry in play therapy are also motivated to reconstruct past events related to their anger.  Otherwise, they could encounter elevated levels of cognitive dissonance (Festinger, 1957) if they should recall pleasant memories involving someone with whom they are supposedly so enraged.  In turn, leading questions and suggestive interpretations can assist children in finding the proper details for a revision of the past that is more consistent with their here-and-now behavior (Siegel, Waters, & Dinwiddy, 1988).

As a vehicle of interpersonal influence that can alter attitudes and beliefs, play therapy becomes progressively more persuasive over time.  Though children appear to control the course of play therapy, therapists actually exercise ultimate control via their interpretative comments.  Play therapists regularly attribute a child's overt behavior to some underlying feelings, and simultaneously, they influence children to amplify and exaggerate the intensity with which they express those feelings.  The therapist can then label the child's feelings as anger or some other similar emotion, and attribute those feelings to an alleged history of sexual abuse.

For example, Dr. Will described how Rachel felt that other children in her school thought badly of her.  She then explained to Rachel, "many kids who have been through sexual abuse will think that the abuse is their fault and believe that they are bad."  Rachel rejected this particular interpretation, but make no mistake, Dr. Will eventually prevailed.  She persistently attributed various experiences reported by Rachel to her alleged history of sexual abuse.  Again and again, Dr. Will explained to Rachel that she suffered nightmares because she had been sexually abused, and she endured unpleasant thoughts because she had been sexually abused, and she related to others in a controlling manner because she had been sexually abused.  Inundated by this unrelenting propaganda week after week, and month after month, Rachel eventually succumbed and began to reconstruct events from her past in accordance with the indoctrination of her play therapist.

For children who are thought to have been sexually abused, the interpretive endeavors of play therapy correspond to a rigid formula:  You are undergoing experience A because of experience B — and experience B almost inevitably equates to a supposed history of sexual abuse.  Thus, play therapists arbitrarily define the formative experiences of children for them.  Indeed, they can patronize children via wildly speculative interpretations that suggest: "Even though you experienced it (some event in the past), you don't understand it; and even though I didn't experience it, your misunderstanding allows me to understand it better than you."  (These interpretive tactics suggest that Lewis Carroll's Mad Hatter would have enthusiastically endorsed play therapy.  He might have described it as "a particularly illuminating exercise — you learn fascinating things about your past that never really happened.  This proves that while truth may be stranger than fiction, fiction is stronger than truth.")

In view of the therapist's source credibility as a kind and gentle figure, children accept these interpretations as legitimate.  They then resort to their imaginations — though convinced they are searching their memories — inventing anecdotes of past events which appear to validate the therapist's interpretations (Bonanno, 1990; Spence, 1982).

Network Formation and Guilt Induction

Play therapy with children of divorce often excludes noncustodial parents, and these circumstances lure play therapists into sympathetic alliances with custodial parents (Campbell, in press-a).  Because a "harmony of minds" (Sartre, 1964) between two or more people affords them mutual feelings of comfort, play therapists accommodate themselves to the influences of custodians.  In turn, they interpret a child's relationship with the noncustodial parent in a manner that corresponds to the custodian's agenda.  While progressively endorsing each other's thinking, play therapists and custodians proceed to interact more frequently because of the views they share.

In their determination to create a "therapeutic alliance" with a custodial parent, play therapists may go beyond a genuine and understanding relationship to the extent of coalition formation.  Weithorn (1987) has described how these coalitions develop — and the problems they create — while summarizing the short-comings of one-sided custody evaluations:

It is possible for psychologists to become slowly compromised by the "us/them" mentality that pervades each side of an adversarial legal dispute (or non-legal dispute); to become tainted by having only half the data pertinent to the case; or to be influenced in some way by financial remuneration.  An insidious process may occur through which psychologists gradually lose their objectivity and unwittingly become partial as advocates for one parent (p. 195).

As an example of the above, Dr. Will explained: "The history that I was given by the stepmother and the father was that Rachel had been sexually abused by Mark R., that he had touched the genitalia, and that there was a concern about oral sex.  They described having gone to the emergency room and having this evaluated..."  Unfortunately, Dr. Will neglected to obtain the emergency room records indicating that there was no substantiation — or even any suspicion — of sexual abuse.  Her error likely corresponded to her readiness for identifying with the cause espoused by Rachel's step mother and father.

Motivated by their mutual concerns for the welfare of a sexually abused child, play therapists and custodians exchange speculations with each other related to the supposed abuse.  They can discuss when it likely transpired, where it could have occurred, and how it might have been concealed.  Any discrepancies in their thinking dissipate as their attitudes about the alleged abuse increasingly gravitate toward each other.  In turn, their evolving consensus can convince them that they have discovered important facts — "We agree, therefore we must be right!"  Thus, play therapists and custodians can verify for each other that some imaginary event actually transpired — and what originated as a worrisome rumor (sexual abuse) acquires the unwarranted status of an indisputable fact (Campbell. in press-b).

Complex social networks often develop in response to allegations of sexual abuse — even when those allegations are false.  For example, Rachel lived in a three generation household that included her father, stepmother, and both paternal grandparents.  As a result of her working relationship with Dr. Will, Kathy frequently spoke with her about Rachel's behavior at home and her response to treatment.  Kathy also shared the details of these conversations with Rachel's father and grandparents, and any one of these adults would discuss issues related to Rachel's treatment directly with her.  As Dr. Will sympathized with Kathy regarding the ordeals that she insisted Rachel had previously endured, Kathy reciprocated by reassuring Dr. Will that her wisdom was aiding Rachel enormously.  Consequently, Rachel was well aware that her father's family and Dr. Will viewed each other with considerable respect.

When play therapists join with custodial parents as sympathetic allies, they can find themselves as influenced by the social network supporting the allegations as they influence that network.  These networks encourage conformity with their constructions of reality by surrounding themselves with a kind of semi-permeable membrane.  Any input, ranging from accurate anecdote to unbridled conjecture, is allowed into the network as long as it assumes that sexual abuse has occurred.  In contrast, input that challenges the veracity of these allegations marks the individual who expresses it as a deviant; and such input is rejected by the network as undeserving of any consideration.

Ultimately, then, play therapists often find their work enthusiastically supported by a social network.  A child who attempts to resist the influence of a play therapist in these circumstances encounters the conformity pressures of a powerful majority (Asch, 1956).  If another respected adult were available to support the child's resistance, the play therapist's influence could diminish accordingly.  Typically, however, the readiness with which these networks reject any views deviating from their own guarantees that no such support is available to the child.  Not surprisingly, then, children conform and comply with the influences of play therapists to avoid the guilt their nonconformity would provoke.

Isolation and Information Control

Play therapists often isolate children from sources of information that might challenge their influence.  For example, when they formally recommend limitations or suspensions of a noncustodian's visitation rights, the noncustodial parent obviously finds it more difficult to defend his reputation.  Play therapists may also resort to "blame-and-change" maneuvers as a means of justifying their arbitrary visitation recommendations.  When play therapists indulge in these maneuvers, children learn that therapy blames your father (or your mother if she is the noncustodian) in order to change you (Campbell, in press-c).

Blame-and-change maneuvers effectively triangulate a child's relationship with the noncustodial parent.  Once triangulated, that relationship is subjected to critical comments by a variety of third parties (i.e., custodial parent, custodial stepparent, grandparents, and the ever kindly play therapist).  These third party observers inform the child that they know more about the child's relationship with the noncustodial parent than the child does.  Consequently the child and the noncustodial parent can no longer manage their own relationship.  Instead, their relationship responds to the influences of various third parties who are often less than committed to the welfare of their parent-child bond.

Dr. Will unhesitatingly influenced Rachel's relationship with her mother by directing ill-informed comments at her about it.  She explained:

On one occasion Rachel talked about being bothered that Mommy, or Cindy, had talked about Mark during a visit, and I talked with her about letting Mommy know that she was bothered by this.  And we talked about what she could do; that — if Mommy talked about Mark, that she could leave, and that she could tell Mommy that she (Rachel) would leave.

This is a particularly chilling example of a play therapist intruding divisively on how a child relates to a noncustodial parent.  Despite the fact that Dr. Will had never observed Rachel's relationship with her mother on a first-hand basis, she attempted to alter that relationship in accordance with her own biases.

When play therapists triangulate a child's relationship with a parent via blame-and-change maneuvers, they ignore the research relevant to children of divorce.  Above all else, the post-divorce adjustment of children is directly related to the quality of their parents' post-divorce relationship (Emery, Hetherington, & DiLalla, 1985; Isaacs, Montalvos & Abelsohn, 1986; Wallerstein & Kelly, 1980).  Children who enjoy stable relationships with both custodial and noncustodial parents adjust more effectively to their parents' divorce.  When play therapists disregard this research and triangulate a child's relationship with a parent via blame-and-change maneuvers, treatment frequently deteriorates into an iatrogenic outcome — the attempt to treat the child's distress only increases its severity.

In his comprehensive examination of the indoctrination procedures developed for American POW's by the Chinese during the Korean war, Schein, Schnneier, and Barker (1961) identified what conditions enhanced the persuasiveness of those tactics.  Not surprisingly, the conditions he specified correspond to the variables previously outlined by Zimbardo et al. (1977).  Schein et al. referred to the procedures employed by the Chinese as "coercive persuasion," but they are more commonly known as "brainwashing."  Regardless of the term chosen to describe such tactics, Schein et al. emphasized that they are neither novel nor unique.

While acknowledging differences in substance related to the agenda of various influence agents, Schein et al. also cautioned against overlooking similarities in method shared by those agents.  He specifically insisted, "There is a world of difference in the content of what is transmitted in religious orders, prisons, educational institutions, mental hospitals, and thought reform centers.  But there are striking similarities in the manner in which influence occur..." (Schein et al., 1961, p.285).  In view of the similarities between play therapy and other persuasive endeavors, one can argue that play therapy qualifies as "brainwashing."

Play Therapy and Malpractice Considerations

Above and beyond the ethical oversights committed by many play therapists who treat children of divorce, the malpractice considerations are even more sobering.  Bennett, Bryant, VandenBos, and Greenwood (1990) have outlined how the exacerbation of a client's presenting symptoms, and the development of new symptoms (i.e. "disruption of previously solid relationships"), increase the malpractice risks for psychotherapists.  When psychotherapy for children of divorce deteriorates into a triangulated relationship, their symptoms frequently worsen and their relationships with one or both parents are often disrupted.

Play therapists sometimes include the noncustodial parent in treatment for their children after they have already established a loyal coalition with the custodial parent.  In these situations, the therapist often remains aligned with the custodian and subjects the noncustodian to accusatory interpretations (Wile, 1984).  Rather than address what needs to be done to resolve the parental conflicts of the present, the therapist suggests why — the noncustodian committed alleged transgressions in the past — and these suggestive interpretations often reflect the custodian's agenda.  Therapists who commit these errors merely fuel the fires of parental conflict that burn between divorced spouses.  This outcome can result in such parental polarization that only supernatural intervention could reverse it.

When noncustodial parents endure the biases of a therapist aligned with their former spouse, they may overgeneralize their experience to all psychotherapists.   As a result, they reject psychotherapy as hopelessly counterproductive, resign themselves to the continued inevitability of disrupted relationships with their children, and bring renewed vigor to future confrontations with their custodial counterpart.  These circumstances also create fertile ground for growing malpractice litigation.  Disillusionment with psychotherapy that leads to feelings of hopelessness is another cause for legal action against psychotherapists (Bennett et al., 1990).

Whether fanning the flames of false allegations of sexual abuse, or neglecting the welfare of children with more conventional problems, play therapy has long avoided responsibility for its frequently counterproductive outcomes.  Therapists who portray themselves as kindly figures playing gently with children appear at least committed to a worthy endeavor — or seem merely benign at their worst.  Obviously, however, this charitable conclusion qualifies as another example of how appearances can be exceedingly deceptive.  Nevertheless, the discovery procedures of malpractice litigation would shed sorely needed light on the massive shortcomings associated with play therapy.

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