Play Therapy Activities For Mental Health In Children

Medically reviewed by Julie Dodson, MA, LCSW
Updated November 1, 2024by BetterHelp Editorial Team
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Scientists and mental health professionals have been using and studying play therapy since the 1920s to assist in treating patients of all ages, although it is most commonly associated with treating children. One effective activity used in play therapy is sand tray therapy, which is designed to give the child a creative way to express themselves in a safe, loving environment.

Until about 16 years old, children's brains are not fully developed enough to link emotions consistently and effectively with words. According to developmental psychologist Jean Piaget, playing gives the child a language that is indispensable to the expression of their feelings.

There are two primary types of play therapy for children:
Directive- The therapist gives the child instructions and then observes the child as they play. The child is guided by the therapist through play activities to help them express themselves.
Non-Directive- The therapist gives the child autonomy to engage in play without interference and observes them as they play in the less controlled environment. 
Play therapy can be used to treat a range of disorders, from autism to trauma to anxiety disorders. Play therapy can also be used in a family therapy setting to allow children to better communicate and develop social skills with family members.
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Caregivers for children in treatment need support, too

Common types of play therapy activities

Play therapy can aid in the healthy development of children. It can help a child master their mental abilities and feel more in control of their environment. Below are some common tools that registered play therapists often use to improve disruptive behaviors, self-control, problem-solving skills, psychological issues, and mental health in young children.

Sand tray

A sand tray is a small box filled with sand, rakes, and small toys. Children use these figures in sand play therapy to represent people and situations in their lives. Therapists use the sand tray in play therapy sessions along with psychotherapeutic techniques to help children work through and make sense of their experiences. There is also an element of sensory play involved with this form of child development therapy.
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Sand therapy may be used to treat children who have experienced neglect or trauma, such as sexual abuse. This type of child play therapy can also be effective for teens and adults who struggle with their mental health and have trouble expressing their feelings.

Game therapy

Game therapy is a type of therapy that consists of playing board games and physical games. Board games can act as a distraction while a play therapist encourages a child to talk about problems, negative emotions, and self-control. Through these self-control games, children can act out episodes and scenarios that affect them by breaking them down into smaller and more specific parts. 
In game therapy, physical games like magic tricks; Mother, May I?; pick-up sticks; Red Light, Green Light allow children to practice taking turns, self-control, impulse control, and more. These play therapy games can also help the child interact with others and, in part, give them a sense of camaraderie with those around them. When the child feels more comfortable, they may be able to better express their emotions throughout the play therapy process.

Toy telephone play 

Toy telephone play is a popular technique used in child play therapy. It involves the child using a toy telephone to role-play different scenarios, such as talking to a parent, friend, or teacher. This technique allows the child to express their thoughts and feelings in a safe and non-threatening way.

Puppet play 

Puppet play is another popular technique used in child play therapy. The therapist uses puppets to help the child express their emotions and feelings. This technique allows the child to externalize their problems and gain a better understanding of their feelings. 

Family puppet interview

The family puppet interview is a family relations technique used to help children express their feelings about family relationships. The therapist uses puppets to represent family members, and the child is asked to interact with the puppets as if they were real people. This technique helps the child identify and express their feelings about their family members. 

Role modeling

Playing the role of someone else and acting out everyday scenarios is a real-world play therapy technique that may help children express their feelings and emotions. Role play is also a great way for children to learn social skills and explore mental and emotional difficulties in a safe space.

The child is encouraged to act out any situation that’s bothering them, such as bullying at school, abuse or neglect at home or in foster care, etc. They can gain insight and express their feelings on their own or with help from the therapist during a play therapy session.

Symbolic play 

Symbolic play involves the use of objects or toys to represent real-life situations. The therapist works with the child to help them explore and understand their emotions and experiences through symbolic play.

Three wishes 

The three wishes technique involves asking the child to make three wishes. This technique can be used to help the child identify and express their desires and aspirations. 

Finger painting

Using finger paint is a fun and creative technique used in child play therapy. It allows the child to express their emotions and feelings through art. This technique is particularly useful for children who have difficulty expressing themselves verbally.

Externalization play 

Externalization play involves using toys or objects to externalize the child's problems. This technique allows the child to view their problems as separate from themselves, which can help them gain a better understanding of their emotions and experiences. 

Three deep breaths

Three deep breaths is a relaxation technique used in child play therapy. It involves asking the child to take three deep breaths, which can help them relax and manage their emotions. This technique may be particularly useful for children who experience separation anxiety or stress.

Other relaxation tools

Many play therapy games are designed to help a child relax so they may feel more comfortable in a therapeutic setting. For example, therapists use tools like calm-down bottles, which are bottles with liquid and glitter, much like a snow globe. The therapist instructs the child to shake up the bottle and then coaches them on how to calm down before the contents of the bottle settle.

The therapist may give the child "worry dolls" to communicate their worries during the session. At the end of the session, the child returns the dolls to their boxes, so they can leave their worries at the office rather than bringing them home. In their future appointments, the child may be encouraged to bring the dolls out one by one and talk about each of the worries and how they can deal with them. This type of baby doll play therapy can be useful for many children. 

Cognitive behavioral therapy (CBT) during play 

Trained play therapists typically use play therapy, such as free drawing or sand tray play, along with cognitive behavioral therapy sessions to help children more easily express their thoughts and feelings. 

Cognitive behavioral therapy aims to help individuals recognize patterns, thoughts, or behaviors that are distressing or unhelpful. It may also help rewire the brain over time so that children can build healthier habits, behaviors, and thoughts.

In the context of play therapy, the play therapist can use CBT by letting children have some time to draw or play and then talking with them about the meaning behind their creations. 

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Caregivers for children in treatment need support, too

The four stages of play therapy

The play therapy process typically follows consistent stages. These include the initial introduction and tentative acceptance stage, the negative reaction stage, the growing stage, and the completion stage. 

A family member, often a parent, will first bring the child to see a play therapist, or a registered play therapist supervisor for an initial intake interview and pre-assessment. 

Once the therapist has established what the child might need the most help with, they can decide on play therapy techniques that will best serve them. 

The first few sessions are about gaining tentative acceptance from the child and increasing their enjoyment of the play therapy room. 

Play therapy activities and therapeutic goals

Once their behaviors begin to evolve, they may demonstrate a negative reaction stage in response to the discomfort. But once they break through this discomfort as play therapy continues, they will progress to the growth stage, where the child responds to the therapy and the therapeutic goals are met. At this point, the child has completed the process and may be discharged from therapy.

Therapy options for you and your child

If you are a parent of a child experiencing mental health difficulties or developmental challenges, it is important for you to find support, too. Speaking to a therapist is recommended in these circumstances to help develop healthy coping skills for the feelings of stress and anxiety that may accompany the role of caregiver. 

Because it offers so much convenience, flexibility, and positive outcomes, many choose to speak to a therapist online. Platforms such as BetterHelp regularly match patients to licensed, accredited therapists with a wide range of expertise. Sessions can be held from home or anywhere with an internet connection, any time that’s convenient for your schedule. 

If your child is between the ages of 13-18 years old, you may also want to consider TeenCounseling,- a platform BetterHelp has dedicated to teens. Read below for some reviews of TeenCounseling and BetterHelp counselors from parents experiencing different issues.

Takeaway

Children develop their expressive language and social skills throughout childhood. They may know they have troubling feelings, but they often can't understand them, or communicate them using words, until they are older and more mature. Play therapy games may help them make sense of angry feelings, for example, and give them an alternative means of expression.

If you’re thinking about having your child speak to a therapist, and you believe they may benefit from child centered play therapy, it's important to vet your options and find an expert with experience in play therapy techniques. A good therapist will work closely with you and your child to assess their needs and develop a treatment plan tailored to them. They will also support your child throughout the therapeutic process and provide a safe, loving environment for them to express themselves fully.

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