Can Trauma Therapy Games Help Individuals With PTSD?

According to the Substance Abuse and Mental Health Services Administration (SAMHSA), more than two-thirds of children reported experiencing a traumatic event by age 16. These events can vary but may include witnessing or experiencing violence, war, natural disasters, parental neglect, vehicular accidents, life-threatening illnesses, and the loss of a friend or family member. To process these events, it may be helpful to use therapeutic tools, such as play therapy and trauma therapy games. These interventions tend to be most frequently used for children, and teenagers and adults may benefit from other types of therapy to address the effects of trauma.

What are the impacts of trauma?

There could be a variety of common responses to trauma that may not necessarily relate to the development of a mental health disorder. These responses can differ depending on the age of an individual and the type of trauma they experienced. While each person is unique, trauma responses often include those that can be classified as emotional, physical, cognitive, and behavioral.

Emotional responses

• Emotional dysregulation: Those who have experienced trauma can struggle to regulate certain emotions, including sadness, shame, anxiety, and anger. This dysregulation may be a short-term reaction to a traumatic event, though in some cases, it could persist and form a pattern. Individuals experiencing emotional dysregulation may engage in various forms of self-medication, such as substance misuse, compulsive or risky behaviors, disordered eating, and emotional repression. 
• Emotional numbing: Trauma can lead a person’s emotions to become disconnected from their thought patterns, memories, and behaviors. This could result in a reduction of a person’s emotional range, potentially leading to muted interpersonal interactions or difficulty expressing emotions related to traumatic events. Emotional numbing may be an unconscious or conscious way to conceal what a person is experiencing internally, which could increase the difficulty of treatment. 

Physical responses

• Somatic symptoms: Somatic responses to trauma can vary, but may include chest pain, body pain, fatigue, dizziness, sleep disturbances, headaches, low energy, and gastrointestinal conditions. Individuals experiencing somatic symptoms may not understand that these physical manifestations could be connected to the trauma they’ve experienced. In other cases, somatic symptoms may become the focus of a person's attention as a way (whether intentionally or unintentionally) to avoid acknowledging the impact of traumatic events. 
• Sleep disturbances and hyperarousal: Those who have experienced trauma can struggle with sleep-related disorders, such as insomnia. Sleep disturbances may also arise due to hyperarousal, a physical state that could lead a person to overreact to minor stimuli, such as loud noises, bright flashes, or sudden movements. 

Cognitive responses 

• Inappropriate feelings of guilt: Individuals who have experienced trauma may struggle to make sense of what happened to them, which could lead to the development of unnecessary guilt. Even if there is no logical basis for it, a person may assume responsibility for a traumatic event. While each situation is unique, this assumption of guilt could serve as a way to process what occurred or to gain a sense of control over what happened. 
• Hallucinations and delusions: Trauma can result in hallucinations, or sensory experiences involving nonexistent stimuli. These hallucinations may or may not relate to traumatic events. Delusions, on the other hand, can involve holding false beliefs. For example, an individual may believe that someone associated with their traumatic event is following them, or that characters on a TV show are talking to them directly.  
• Intrusive thoughts and flashbacks: Those experiencing trauma may have involuntary thoughts or memories of traumatic events. These thoughts or memories may happen quickly, disrupting what they are doing and leading to significant behavioral or emotional reactions. In some cases, these intrusions may be more intense, coming in the form of flashbacks. Flashbacks can completely overtake an individual's senses and usually involve vividly re-experiencing traumatic events. 
• Dissociation: Trauma can also lead to dissociation, or a disconnection from one’s thoughts, feelings, and bodily sensations. These feelings could last for a few hours, or, in some cases, for days, weeks, or months. In some cases, dissociation may be a way for an individual to unconsciously cope with trauma. 

Behavioral responses

• Maladaptive coping techniques: Those who have undergone trauma may cope with their experiences in ways that could be considered unhealthy. For example, individuals who have experienced trauma could misuse substances like alcohol to reduce stress. Others may eat compulsively or engage in high-risk behaviors. 
• Reenacting trauma: Trauma can lead a person to reenact what they experienced as a way to understand what occurred. This may involve engaging in a variety of sexual, risky, reckless, or destructive behaviors. Reenactments can be easier to notice in children. For example, if a child was in a serious car wreck, they may repeatedly reenact the event with toy cars. 

While individuals who experience trauma or these responses won’t always develop a trauma-related disorder, it can be possible. One of these disorders is post-traumatic stress disorder (PTSD).

What is PTSD? 

Post-traumatic stress disorder is a mental health condition that may affect those who have experienced trauma. According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V), the diagnostic criteria for PTSD include the following:

• Exposure to life-threatening situations, death, sexual violence, or serious injury in a way that involves either directly experiencing or witnessing the event, learning that a loved one experienced the event, or repeated exposure to details of the event
• The presence of intrusive symptoms associated with the traumatic event, including intrusive, recurrent, and involuntary memories or dreams, dissociative reactions, intense or prolonged psychological distress when exposed to reminders of the event, and physiological reactions to reminders of the event
• Avoidance of stimuli that can be associated with the traumatic event or events, including distressing memories, feelings, or thoughts; in addition, individuals with PTSD could avoid people, places, objects, situations, or activities that may remind them of traumatic events
• Cognitive or mood alterations associated with a traumatic event, including those that relate to memory, expectations about oneself or the world, distorted understandings of the cause or consequence of the event, persistent negative emotional state, diminished interest in previously interesting activities, a sense of detachment from others, and an inability to experience positive emotions
• Alterations in reactivity and arousal associated with trauma, including irritability, recklessness, hypervigilance, sleep disturbances, being easily startled, and difficulty concentrating

The DSM-V also states that the duration of the disturbance must last longer than one month, cause clinically significant distress or impairment in important areas of function, and cannot be attributed to the effects of a medical condition or substance. 

While the precise way to treat PTSD may vary based on a person's age, several therapeutic approaches could be effective. For younger individuals, one type of therapy that may be beneficial is play therapy, which could involve the use of trauma therapy games. 

Can play therapy and trauma therapy games help those with PTSD? 

Trauma therapy games can be one aspect of play therapy, a therapeutic approach that generally allows children to express their feelings and thoughts using toys. Play therapy sessions are often guided by a mental health professional trained in child psychology. 

During these sessions, a child may be provided with a variety of toys and guided through different trauma therapy games. While they are playing, their therapist will typically watch and ask questions. These questions may seek to identify why a child is using a particular toy and how they are playing with the toys. This could reveal insights into the type of trauma a child has experienced and their perspective on what occurred. 

Are you struggling with a traumatic experience?

Discuss coping skills with a therapist

However, play therapy and other in-person forms of mental health treatment may not be available to everyone. Some individuals, including parents or those who are in school, may not have time to attend face-to-face therapy sessions. Others could lack health insurance, which could make it more difficult to find a provider, or might prefer to speak with a therapist through phone calls, video conferences, or online chat. 

In these cases, it may be necessary to explore alternatives. These can include BetterHelp for those over the age of 18, or TeenCounseling for those between the ages of 13 and 17. 

Research indicates that online therapy may be an effective way to treat certain trauma-related disorders, such as PTSD. In a 2022 study, 196 participants who had been diagnosed with mild to moderate PTSD were separated into two groups—one receiving online therapy and the other receiving in-person therapy. Researchers found that online therapy generally had a similar level of effectiveness as in-person therapy, while also being significantly less expensive.