[1] Psychology Resources Team

Play Therapy: What Is It and How Does It Work?

Psychology Resources Team

The moments when we feel most alive and energized often coincide with times
of play (Price, 2022).

“Play by its nature is a creative, spontaneous, and often pleasurable activity”

(Meersand & Gilmore, 2017, p. 19). As a therapy, it is a psychoanalytically derived
treatment that requires skills, knowledge, and resources from the therapist.

When working with children, play therapy can break down barriers and improve
relationship building, creating a safe and motivating environment for a better
treatment outcome.

This article defines play therapy, introduces several theories, and explores how
it benefits both young and older clients.

This Article Contains

• What Is Play Therapy? A Definition
• 4 Common Play Therapy Theories
• What Are the Benefits?
• Why Play Therapy? How Does It Work?
• Types of Play Therapy
• Who Can Benefit from Play Therapy?
• A Take-Home Message

What Is Play Therapy? A Definition

“As an organically emerging capacity, play represents a natural mode of self-
expression and an ideal medium for communicating and building relationships
with children between ages 3 and 8 or so” (Meersand & Gilmore, 2017, p. 18).

Psychology Resources Team! Click the link: https://wa.me/message/VOJHRDL42E56I1

 [2] Psychology Resources Team
Play and other symbolic functions emerge during the early phases of child
development, including narrative language and mentalization. It involves
“transforming passive experience into active mastery; modulating intense
affects; making meaning of emotionally laden events; trying on others’
perspectives; and sampling roles and identifications” (Meersand & Gilmore, 2017,
p. 437).

Early on, psychoanalysts were quick to recognize play as an opportunity to drive

wish fulfillment, assimilate reality, and master developmental anxieties
(Meersand & Gilmore, 2017).

More recently, research has seen play therapy as a powerful tool in treating
children, offering a medium for communication, relationship building, and
therapeutic action.
Psychology Resources Team

Rather than more formal approaches, such as exploratory skill practice, play
engages the intentional projection of the child’s mental representation onto
reality while remaining aware that it is a pretense.

When play therapists refer to “pretend play” (including fantasy, imaginative,

dramatic, and make-believe), they are typically describing circumstances that
(Meersand & Gilmore, 2017):

• Uniquely combine physical action with mental fantasy or role-play

• Have an inherent “behaving as-if” quality
• Engage and immerse children fully despite awareness that it is pretend
• Create an environment that is inherently safe and nonconsequential

Contemporary psychodynamic theories also see play therapy as encompassing

the following defining elements (Meersand & Gilmore, 2017):

• Play therapy offers a window into age-relevant anxieties and fantasies and is
powerful for communication, assessment, and treatment, especially in younger
children.
• Play therapy incorporates information from various fields and recognizes the
importance of biological factors, attachment relationships, and cultural
influences for the child.

As such, play therapy is recognized as a development-appropriate language for

working with children and serves to promote the relationship between therapist
and client as a primary healing factor for children experiencing contextual,
developmental, and internal difficulties (Crenshaw & Stewart, 2014).

Play also has the potential to help children learn and develop many life-affirming
and enhancing skills, including coping. “In play therapy, the play becomes

Psychology Resources Team! Click the link: https://wa.me/message/VOJHRDL42E56I1

 [3] Psychology Resources Team
transformative in providing a new perspective on the self and/or the
environment, which is at the heart of resilience as a therapeutic power of play”
(Crenshaw et al., 2015, p. 33).

What is Theraplay®?

Play can be particularly valuable in helping young trauma survivors (Crenshaw &
Stewart, 2014).

While sometimes confused with play therapy, Theraplay® is more adult

directed, with activities tailored to the child’s current emotional level rather
than their chronological age (Attachment and Trauma Network, 2020). “The
focus of treatment is the parent–child relationship itself” (Crenshaw & Stewart,
2014, p. 141).
Psychology Resources Team

One of its goals is for the parent to learn to respond to their child’s (sometimes
confusing) signals; foster an increased sense of safety, security, and shared
meaning; and create stronger connections while attuning to their client’s needs.

Typical treatment duration is 30–40 minutes once a week and can last for
between 18 and 20 sessions.

Over the course of the treatment, the parent is encouraged to begin taking
control of the play from the therapist and, as a result, develop stronger internal
family bonds (Attachment and Trauma Network, 2020).

4 Common Play Therapy Theories

Play therapy continues to evolve and develop with innovative thinkers and
inspiring leaders driving theories and models for use with children, adolescents,
and adults in therapeutic treatment (Crenshaw & Stewart, 2014).

Four common play therapy theories include:

Child-centered play therapy

Like other play therapies, child-centered play therapy recognizes play as a

developmentally appropriate language for treating children.

However, it differs in that its focus is on “the relationship and environment as

sources to health and functioning,” with the therapist understanding and
accepting the child’s world, their receptivity to treatment, and potential to move
“toward self-enhancing ways of being” (Crenshaw & Stewart, 2014, p. 3).

Psychology Resources Team! Click the link: https://wa.me/message/VOJHRDL42E56I1

 [4] Psychology Resources Team
In line with person-centered therapy:

• The client’s perceptual field is seen as their “reality.”

• The client strives toward independence, maturity, and self-enhancement.
• The client behaves in a way that is consistent with their self-concept.
• The client operates as an organized whole.

Ultimately, when a child is given a warm, welcoming environment and a genuine

relationship, they can feel comfortable expressing themselves and determine
their direction for therapeutic change (Crenshaw & Stewart, 2014).

Cognitive-Behaviour Play Therapy (CBPT)

CBPT “is a part of cognitive-behavioural approaches aimed to dislodge and

Psychology Resources Team

deactivate maladaptive social behaviours and phobia credited to dysfunctional

thoughts and replace them with better ones” (Obiweluozo et al., 2021, p. 2).

While Cognitive-Behavioural Therapy is predominantly verbal and, therefore,

less suitable for younger clients, when combined with play, it is possible to use
fantasy and make-believe to engage several affective processes, including
expressing emotion, emotional regulation, and cognitive integration (Crenshaw
& Stewart, 2014).

CBPT engages the client in the following processes:

• Insightful and flexible problem-solving

• Diverse thinking
• Considering alternative coping strategies
• Increasing experience of positive emotions
• Improving emotional awareness and understanding

Family play therapy

Family play therapy has a place in the long history of treatments designed to
support and address the wellbeing of the individual and the family as a whole.
Family play therapy aims to bring the power of play to families by inviting them
to “imagine and participate in creating an alternative vision of what family can
be” (Crenshaw & Stewart, 2014, p. 187).

The treatment has the potential to shift mental models and structures and
redefine daily life, working with the family as a whole rather than “fixing” the
child. As such, the therapist must:

• Have a genuine and deep interest in working with families

• Enjoy the process of family therapy

Psychology Resources Team! Click the link: https://wa.me/message/VOJHRDL42E56I1

 [5] Psychology Resources Team
• Remain comfortable with ambiguity
• Notice small indicators and their implications for larger relational patterns
• Show respect for all family members
• Have high emotional stamina
• Maintain a playful style and a genuine sense of humor

Psychodynamic play therapy

“The psychodynamic therapist sees the reasons for behaviour as more complex
than what is revealed by observable behaviour” (Crenshaw & Stewart, 2014, p.
66). Play can be a helpful tool for examining how children’s feelings lead them
toward specific problematic behaviour and arise from deeper underlying
problems.
Psychology Resources Team

Psychodynamic play assumes that:

• Symptoms have meanings.

• Problems arise from unconscious conflicts and failing to assimilate
overwhelming experiences and cope with developmental difficulties.
• Children’s play is symbolic.
• Children’s behaviour is characterized by transference-based thoughts (in and
outside therapy).

Play helps children move to developmentally higher levels of functioning, having

previously been halted by trauma or internal conflict.

What Are the Benefits?

Play therapy is recognized as “an effective intervention for children’s problems,
one that is uniquely responsive to children’s developmental needs” (Bratton et
al., 2005, p. 385).

Research has uncovered wide-ranging benefits from adopting play therapy

techniques in the treatment of children’s unique and varied developmental
needs (Bratton et al., 2005; Obiweluozo et al., 2021; Helping children, 2019).

• It offers treatment opportunities for children (typically below the age of 11) who
lack a fully developed capacity for abstract thought.
• It provides a concrete and accessible means of communication when verbal
skills are lacking.
• It offers materials and opportunities to act out feelings, experiences, and
thoughts symbolically or directly that they cannot express through words.
• It supports children in bridging the gap between experiences and
understanding.
• It provides opportunities for insight, problem-solving, and skill mastery.

Psychology Resources Team! Click the link: https://wa.me/message/VOJHRDL42E56I1

 [6] Psychology Resources Team
• It works through perceived social, behavioral, and cognitive aspects of emotions.
• It encourages children to develop new and creative solutions to problems.
• It helps children develop empathy and respect for others and what they think.
• It helps children learn new social and relational skills.

Why Play Therapy? How Does It Work?

Psychology Resources Team

“Unlike adults who communicate naturally through words, children more

naturally express themselves through the concrete world of play and activity”
(Bratton et al., 2005, p. 376).

Whether it involves straightforward playing with games and toys, role-play, or

synergetic play therapy (where the therapeutic power of play is blended with
nervous system regulation), play is viewed as a vehicle that supports natural
communication between child and therapist (What is synergetic, 2022).

The child plays out thoughts, feelings, and emotions they might not otherwise
be able to express meaningfully through their words (West, 2022; Bratton et al.,
2005).

As the child acts out their feelings, directly or symbolically, the therapist can
gain insight into their emotional state. And playing together offers a safe
environment for the child to express how they feel while interacting with the
world and those in it and developing coping, problem-solving, and resilience-
related skills (West, 2022).

While typically used with children, play therapy is also effective with
adolescents and adults in treating anxiety, depression, trauma, and behavioral
disorders (West, 2022; Doyle & Magor-Blatch, 2017; Rozenova et al., 2022).

Types of Play Therapy

While many different play therapy theories exist, most treatment styles can be
divided into directive or nondirective interventions (Crenshaw & Stewart, 2014).

Psychology Resources Team! Click the link: https://wa.me/message/VOJHRDL42E56I1

 [7] Psychology Resources Team
Directive

Directive interventions typically involve behavioral, cognitive, and directed

activities, such as playing board games or solving puzzles, and are often
described as nonhumanistic (Bratton et al., 2005).

Such activities are usually task based, structured, and goal oriented rather than
open ended, with the therapist taking charge of regulating the pace and
intensity of exposure to painful events and emotions, such as grief (Obiweluozo
et al., 2021; Crenshaw et al., 2015).

The degree of directiveness varies and should remain flexible according to the
needs of the client and their treatment environment. The therapist may
introduce new characters or variations to the play to help the child move
Psychology Resources Team

forward and become “unstuck” (Crenshaw et al., 2015).

Nondirective

According to some research, humanistic — or child-centered — nondirective

play therapy interventions have produced significantly positive treatment
effects beyond directive interventions (Bratton et al., 2005).

After all, there are times when the child does not need the precise direction of
the therapist.

Children can often accomplish a great deal through their play, particularly when
provided with toys that serve as gentle reminders (particularly in relation to
trauma) with no clear direction (Crenshaw et al., 2015).

Who Can Benefit from Play Therapy?

Play therapy benefits diverse
populations. While primarily
used for treating children, it can
be helpful for adolescent and
adult populations (Crenshaw &
Stewart, 2014). The following
includes a sample of four
specific groups that research
shows can benefit from play
therapy.

Psychology Resources Team! Click the link: https://wa.me/message/VOJHRDL42E56I1

 [8] Psychology Resources Team
Play therapy for adults

Despite its prevalence in treating children, play therapy can offer fascinating
benefits to adult populations.

A 2017 systematic review of the research studied its application in rehabilitating

adults with adult-acquired brain injury. Play therapy can benefit those who have
experienced traumatic brain injury and strokes, helping them improve mobility,
balance, and independence, and is rated more enjoyable than traditional
treatments (Saywell et al., 2017).

Play therapy also proves a successful treatment in adults experiencing extreme

trauma.
Psychology Resources Team

Studies suggest it is an effective intervention for helping clients “because play

addresses areas of social, emotional, and cognitive development compromised
from chronic personal exposure in early childhood” (Olson-Morrison &
Hudspeth, 2017, p. 172).

Play therapy for kids

Play therapy is highly valued as a treatment for children, particularly when they
lack the verbal skills to share their feelings (Crenshaw & Stewart, 2014).

There are also some more unusual applications.

Cognitive Behavioral Play Therapy has been shown to reduce social anxiety
among children with stuttering. The authors of a 2021 study suggest that it is
valuable for young people with speech deficits experiencing difficulties in their
social relationships, such as withdrawal and low self-esteem (Obiweluozo et al.,
2021).

Other research has confirmed the value of play therapy for supporting children
experiencing bullying, trauma, divorce, and anxiety (Crenshaw & Stewart, 2014).

Play therapy for autism

Play therapy is a highly effective approach for children and adolescents on the
autism spectrum. It is beneficial for (Crenshaw & Stewart, 2014):

• Increasing social skills

• Improving emotional control
• Decreasing negative emotions
• Increasing verbal expression

Psychology Resources Team! Click the link: https://wa.me/message/VOJHRDL42E56I1

 [9] Psychology Resources Team
• Improving verbal activity
• Strengthening relational connections
• Increasing coping skills and adaptability

Some characteristics of being on the autism spectrum can cause challenges in

play therapy.

Children with autism may struggle to form close bonds due to deficits in joint
attention, which can damage the therapeutic bond and ultimately put a
successful treatment outcome at risk. In addition, children may have a particular
toy or game they prefer and refuse to play with another. As with other therapies
and populations, unconditional positive regard remains vital for success
(Crenshaw & Stewart, 2014).
Psychology Resources Team

Play therapy for ADHD

“Attention-deficit/hyperactivity disorder (ADHD) is one of the most commonly

diagnosed neurobehavioral disorders in children” (Crenshaw & Stewart, 2014, p.
415). Where once it was described in terms of overactive and inattentive
behavior, it is now characterized by deficits in executive function and
motivation (Crenshaw & Stewart, 2014).

Play therapy in children with ADHD typically involves multiple techniques and
has proven successful in helping them learn more adaptive coping skills, through
doing rather than being told how to behave.

Well into their adolescent years, those with ADHD can find play therapy a
helpful tool to express and relate through play.

Authors of a recent case study reported that cognitive play therapy is highly
effective at reducing anxiety and aggression in a child with ADHD who has
experienced physical abuse (Hassani et al., 2021).

A Take-Home Message
Play creates moments of energy and insight and opportunities to motivate
change.

For children in therapy, it offers a mode of communication that does not rely on
verbal skills and provides a safe environment to build a solid therapeutic bond
that facilitates a path to a positive treatment outcome.

Research has confirmed play therapy as a powerful tool in treating children,

adolescents, and young adults and providing an opportunity for growth in
communication, relationship-building skills, and therapeutic action.

Psychology Resources Team! Click the link: https://wa.me/message/VOJHRDL42E56I1

 [10] Psychology Resources Team
Play therapy combines play, role-play, fantasy, and “behaving as-if” to create a
nonconsequential environment that can be a window to age-relevant anxieties,
concerns, emotional states, and trauma.

Ultimately it is a development-appropriate language for working with children

and serves as a potential healing factor for clients experiencing contextual,
developmental, and internal difficulties.

Incorporating aspects of play into therapy with any age group — but especially
children and young adults — can support clients’ development of life-affirming
and life-enhancing skills, such as resilience, problem-solving, emotional
awareness, and communication.
Psychology Resources Team

Source: Google
To get such exclusive psychology resources join our WhatsApp
channel:
https://whatsapp.com/channel/0029Va4cUYi7tkjAQFo0RW00

Psychology Resources Team! Click the link: https://wa.me/message/VOJHRDL42E56I1