LCSW #LCS20238 and registered play therapist Debra Holmes earned her MSW from San Diego State University in 1993 and was licensed in California in 2001 before opening her Hillcrest private practice at 3821 Front Street in 2004. The child and family caseload builds on prior clinical work at Rady Children's Hospital and the Chadwick Center Trauma Counseling Program, with autism cases co-managed alongside the school-day behavioral team at ACES Academy - Autism Education Center when classroom support is part of the treatment plan. The practice draws on more than 70 hours of training with Daniel Hughes, PhD in dyadic developmental psychotherapy, an attachment-focused model used with adopted and foster-placed children. A 150-hour play therapy certificate completed through UCSD Extended Studies in 2002 underpins the sandtray, expressive arts, and structured play protocols applied to ages four through twelve. Adoption and foster placement matters often run parallel to adult marital work handled by the family-systems clinicians at San Diego Family Institute, since the play-therapy room does not take on the couple component. The most complex assignments involve court-involved foster and adoptive children carrying layered developmental trauma, where attachment-focused play therapy runs alongside caregiver coaching across multiple home placements.