What Is Play Therapy And How Does It Work?

What could be more natural for a child than play? Children instinctively use it as a means of communication. And that’s precisely why play therapy can work as a therapeutic tool. Here the child forms a relationship with a trained play therapist so that they can safely explore, express, and understand painful or difficult life experiences. But do keep in mind that play therapy is very different from normal play. Here’s what it’s all about.1

Play Therapy In Theory

Play therapy has its roots in child psychotherapy, with a focus on attachment theory – a model that looks at how children “attach” emotionally to their parents and the impact this has on their development2 It also draws from the humanistic psychology tradition and its focus on the inherent value of human beings and their capacity for self-determination.3.


Principles Involved In Play Therapy

Three important principles form the basis of play therapy.

1. The Drive Toward Actualization

People are naturally programmed for healthy and constructive growth. There is a drive in all of us to actualize inner potential, including aspects like creativity, and the desire to be more independent and effective.


2. The Importance Of Positive Regard

People need acceptance, warmth, and respect from other people, particularly those who are significant to them. As children develop and grow, this requirement for positive regard changes into a need for self-regard that’s positive.

3. Communication Through Play

While different theories and practices are used in play therapy, a central proposition that connects them is the idea that play expresses a child’s unconscious thoughts, experiences, emotions, and desires.4


Play Therapy In Practice

Play therapy provides a non-restrictive play environment where the child can re-enact damaging experiences symbolically. The content and pace of the sessions are usually directed by the child. The therapist sets limits and focuses on the feelings experienced by the child. These feelings and thoughts are brought to the conscious mind and represented symbolically. And by progressively understanding these symbols, it’s possible to change the mindset of the child. This brings changes in behavior in tandem.5

Play Therapy Sessions: An Example

Play therapy can take different forms, including movement play, sand play, social play, pretend or fantasy play, nature play, storytelling, creative play, and vocal play. Let’s take a look at one concrete example of a session of play therapy.


Sandtray therapy is a form of play therapy in which the child uses toys or figures and sand to design a miniature world. The sand tray usually contains things that represent people of different ages, occupations, or races; animals; religious artifacts; symbols of death, life, and love; things from nature like shells, flowers, or stones; buildings that stand for houses, church, or school etc. Many children enter a sand tray room and start working instinctively without directions, while others may need some prompting to create their world or tell a story in the sand. After the world is created, the therapist will process it by inviting the child to tell their story. A sand tray built during therapy is also documented photographically for the records.6

Stages Of Play Therapy

Play therapy will usually proceed through 7 stages:


1. The Intake Interview

The play therapist will start the process by interviewing the child’s parent’s about aspects like early development, how the child functions currently, and what the problem is. Most therapists will also interview the child to make sure that they are engaged in the process and to understand their side of the problem.

2. Pre-treatment Assessment

The play therapist may also do a pre-treatment assessment which may consist of questionnaires, drawings, and observation of the child playing. This gives the therapist additional information about difficulties faced by the child and how best to go about treating them. It may also be helpful in assessing the child’s progress later on.


3. Introduction

The initial few sessions are known as the introduction phase. During this time, the child will get familiar with the therapist, the process of therapy, and the playroom. If the child is anxious or shy, this phase can be a little difficult. But the idea is to ease the child in.

4. Tentative Acceptance

After a few sessions, the child will move into the phase of tentative acceptance. By this period, children usually look forward to therapy sessions and interacting with the therapist.


5. Negative Reaction

The child will start to make certain changes as the therapy begins working. These changes may be essential, and yet uncomfortable and difficult to make. For instance, your child may oscillate between trying to engage in new healthy behaviors and falling back to old comfortable behaviors. This period is known as the negative reaction period and some children may get worse and resist therapy during this phase.

6. Growing

This is the most important phase where the child will gain an understanding of their problems and how to deal with them. Usually, they’ll make important advances and then slide back into unhelpful behaviors. Although these regressions can be somewhat frustrating, they tend to settle down if the process is followed meticulously.

7. Termination

Termination is the last phase of play therapy. It is initiated when the child, the parents, and the therapist are confident that the child is functioning in a stable way and will be able to maintain takeaways from therapy without regular sessions. This period can be a little difficult for some children as they may see termination as a punishment rather than a sign of success. This, in turn, may prompt a temporary recurrence of some problem behaviors. But by conveying their confidence in the child’s ability to remain healthy, parents and other caregivers can turn the end of therapy into a celebration of the child’s success.7

How Play Therapy Can Help

Play therapy offers many benefits:

  • It can give a child emotional support during a difficult time.
  • It can help a child make sense of experiences and feelings they are struggling with, at their own pace.
  • It can help a child deal with anger or conflict in an appropriate way.
  • It can help parents understand the child’s world better.8

Who Can Benefit From Play Therapy?

Play therapy can be a useful intervention for:

  • Children dealing with adoption or fostering.
  • Children who are aggressive or tend to act out.
  • Children who have anxiety, depression, or attachment problems.
  • Children coping with chronic illnesses, grief, or loss.
  • Children dealing with sibling rivalry, difficult peer relationships, or trouble in school.

It can also be an adjunctive treatment for emotional problems that accompany conditions like autistic spectrum disorders, speech problems, attention deficit disorder etc.9 10

An important criterion for participating in play therapy is the capacity to engage in symbolic play. This means that very young children, perhaps below the age of 3, may not benefit from it. It may also exclude children with very severe developmental delays. At the other end of the spectrum, adolescents may not wish to engage in play therapy and may prefer to be treated as “adults.”11 But this is something the therapist will be trained to tackle.

Play Therapy For Adults, Too

Incidentally, although play therapy was conceived as a therapeutic approach to help children, it is increasingly being used among adults, including the elderly. The focus is on relearning the value of play and using these to tackle health challenges. These may include problems like:

  • Posttraumatic stress
  • Obsessive compulsive disorders
  • Dementia
  • Mood issues
  • Anxiety or depression
  • Loss and grief

The objective here is to provide the adult a safe and non-threatening environment in which to explore and express their thoughts and issues. The creativity involved also helps them drop their guard and let go of the tendency to rationalize, leading to deeper and more meaningful interactions with the therapist.1213