Play Therapy

Medically reviewed by Dr. Andrea Cziffer Paul, MD, Andrea Brant, LMHC, and Laura Angers Maddox, NCC, LPC

Overview

Play therapy comes from the early 20th century, drawing from the foundational theories of psychoanalysis and child development. Figures such as Anna Freud and Virginia Axline contributed to the field of play by establishing therapeutic methods for children. Over time, play therapy has evolved to incorporate various theoretical frameworks, ranging from psychodynamic to cognitive-behavioral approaches.

There are two main types of play therapy: directive and non-directive. Directive play therapy is structured and guided by the therapist,¹ who introduces specific activities or themes to address particular issues. Alternatively, non-directive play therapy (often associated with the client-centered approach) allows children to take the lead by choosing toys and activities freely. This approach to play therapy assumes children will naturally move toward problem-solving and emotional healing when given a safe and accepting environment.

Play therapy is administered in various settings to meet the diverse needs of children and their families. Hospitals often incorporate play therapy into their treatment plans, especially in pediatric units where children may be coping with illness or injury. Individual practices offer a more controlled environment, allowing therapists to use various materials and techniques tailored to individual children. Schools are another common setting for play therapy, particularly for addressing behavioral challenges, improving social skills, and helping children cope with academic pressures or family concerns.

Play therapy's flexibility and adaptability have helped gain widespread recognition as an effective therapeutic intervention² for children, making it a staple in various settings to address young individuals' emotional and psychological well-being.

What to expect

The initial assessment is the first step when an individual begins play therapy. This usually involves a meeting with the child and their parents or caregivers to gather background information and identify specific issues or challenges. Some play therapists may also use standardized assessments or questionnaires to understand the child’s needs better.

During play therapy sessions, a variety of tools are commonly used, each serving specific therapeutic purposes:

Toys: Basic toys like dolls, cars, and building blocks allow children to engage in imaginative play and express feelings or thoughts indirectly.
Art supplies: Materials such as crayons, markers, and paper provide an outlet for creative expression and can be helpful for children who find it easier to communicate through art.
Sand trays: These allow for tactile exploration and can be effective for children to enact scenes or situations they find difficult to articulate. This may involve the use of small tools or figurines.
Musical instruments: Drums, xylophones, or similar small handheld instruments can be used to explore emotions through sound and rhythm.

A typical play therapy session may last 30 to 50 minutes, though this may vary depending on the child’s age and specific needs. Depending on the approach employed, the child may explore the room, select from various activities, or interact directly with the therapist during the session.

Parental or caregiver involvement varies according to the therapist’s play model and the child's needs. Some approaches encourage parents to actively participate in sessions, especially for younger children. In other models, parents may meet with the therapist separately to discuss progress, concerns, and any observations they have made outside the play therapy room.

Understanding what to expect in play therapy can help ease anxieties and facilitate a more effective and therapeutic experience for children and their caregivers.

Who play therapy benefits

Play therapy is primarily aimed at children between the ages of 3 and 12. This age range is considered optimal as children within it are often more engaged in imaginative play and might find it easier to express their emotions and thoughts through activities rather than verbal communication.

Play therapy may be effective for various mental health conditions and life situations, including:

Anxiety disorders: Helps children develop coping mechanisms and explore the sources of their anxieties in a safe space
Attention Deficit Hyperactivity Disorder (ADHD):³ Assists in improving focus and self-control by providing structured activities that challenge and engage the child
Autism spectrum disorders: Offers a means to improve social interaction and communication skills
Grief and loss: Provides an outlet for children to process complex emotions and navigate through the stages of grief
Family issues: Useful for children coping with divorce, adoption, or other family-related stressors by providing a space to explore emotions and family dynamics

Candidates for play therapy usually exhibit signs of emotional or behavioral issues that interfere with their daily lives, such as trouble in school or relating to peers or family. Play therapy can benefit those who struggle with verbal expression or have had adverse life experiences that are challenging to articulate.

While play therapy is mainly designed for children, adults may also benefit from this approach. Specifically, adults who face challenges with emotional regulation, have experienced trauma,⁴ or struggle with mental health challenges that impact their daily functioning may find value in the techniques employed in play therapy. Play therapy can be a beneficial tool for individuals of all ages by providing an alternative avenue for expression and self-exploration. However, its primary focus remains on aiding the emotional and psychological development of children.

For those experiencing trauma, support is available. Please see our Get Help Now page for more resources.

Goals for therapy

Like other therapeutic approaches, establishing clear goals in play therapy helps ensure a structured and effective therapeutic process. Goals can be categorized into short-term and long-term objectives. Short-term goals often focus on immediate issues, such as reducing anxiety symptoms, improving social skills, or enhancing emotional regulation. Long-term goals might involve more complex aims like fostering self-esteem, improving familial relationships, or achieving sustained behavioral change.

Progress in play therapy is measured through a combination of methods. Observational data from sessions, parental or caregiver feedback, and sometimes standardized assessments are used to track advancements. Some therapists might use rating scales or behavior charts to track changes, while others might rely on qualitative observations and subjective reports from the child and parents.

The goals set in play therapy can vary depending on the individual child’s condition or needs. For instance, children with autism may have goals centered around improving social interactions and communication skills. Alternatively, a child experiencing grief might have goals focused on emotional expression and understanding the stages of grief. Specific behavioral issues might require goals from therapy, like impulse control or anger management.

Additional considerations may involve tailoring the therapeutic approach to suit the child’s developmental stage. Younger children may have goals set in simpler terms, aligned with their capacity for understanding, while older children may engage in more complex problem-solving and emotional exploration. Family dynamics can also influence play therapy goals. For example, in cases involving divorce or other disruptions within a family, objectives may extend to improving the child’s coping mechanisms and adaptability to new family structures.

The goals in play therapy are often diverse and multi-faceted, tailored to each child’s unique needs and conditions. They serve as the guiding framework that helps the therapist and the family measure progress and make meaningful changes through play.

Research

Research studies on play therapy can offer valuable insights into its efficacy across various settings and populations. These studies commonly explore aspects like anxiety reduction, emotional regulation, and enhanced communication skills to provide a comprehensive understanding of the therapy’s impact.

Healthcare published a comprehensive review of studies in which play therapy emerged as a highly effective therapeutic approach for hospitalized children. Play therapy notably reduces anxiety and postoperative pain while enhancing the child’s behavior and attitude during hospital stays. It addresses cognitive, affective, and interpersonal domains, allowing children to understand medical procedures better and build trust with healthcare providers. By transitioning from passive to active roles through therapeutic games, children feel safer and more in control, improving their overall well-being. Play therapy is adaptable and can include toys and sanitary materials to simulate real procedures. The studies in the review affirm the need for trained staff in pediatric units to implement play therapy for its multi-faceted benefits.

Early Childhood Development and Care published a study evaluating the efficacy of CCGPT (Child-Centered Group Play Therapy), narrative therapy, and a combined group intervention in treating separation anxiety disorder (SAD) and improving social-emotional behaviors in preschool children. Results showed that both CCGPT and the combined play group reduced separation anxiety symptoms, while narrative therapy did not. However, all three interventions positively impacted children’s social-emotional behaviors and increased prosocial behaviors compared to a control group. These findings confirm the effectiveness of CCGPT and combined approaches in treating separation anxiety and enhancing social-emotional competencies in young children.

Finding therapy

Finding the right play therapist is the first step for families seeking effective therapeutic intervention for their child. One traditional way is through a referral from a pediatrician, school counselor, or other mental health professionals. Organizations like the Association for Play Therapy provide online directories where parents can search for play therapists in their area.

In the digital age, virtual options like BetterHelp are also available. BetterHelp offers a platform for online therapy. It allows for remote sessions where the child and therapist engage in therapeutic activities through a video connection.

Here are some tips for parents or caregivers looking to find the right play therapist:

Check credentials: Ensure the therapist is certified in play therapy or has relevant experience working with children.
Conduct an interview: Have a preliminary meeting with the therapist to discuss their approach, your child’s needs, and any other concerns you might have.
Observe interaction: Pay attention to how the therapist interacts with your child during the initial sessions. A good rapport is important for effective therapy.
Seek reviews or references: Ask for testimonials or speak to other parents who have used the therapist’s services.
Consider logistics: Factor in location, frequency of sessions, and cost when making your decision.

Finding the right play therapist involves careful research, consideration of various options, and observation. Whether opting for traditional in-person therapy or exploring virtual services like BetterHelp, the key is finding a qualified professional who can effectively meet your child’s needs. This decision can be a beneficial step toward achieving emotional and psychological well-being for your child, making the effort to select the right play therapist incredibly worthwhile.

Associated terms

Updated on September 19, 2024.

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