What Is Play Therapy and How Does It Work?

February 13, 2023

A child therapy client is using blocks in a play therapy session with a female therapist

When I began my counseling internship, I found myself stumped when it came to working with children. The techniques I’d learned in counseling courses just didn’t cut it with child therapy clients.

Children would rather explore my office than talk about things they didn’t understand.

I couldn’t ask a five-year-old to identify the negative cognitions which fueled his depression.

Nor could I expect an eight-year-old to talk through the emotional impact of her parents’ divorce.

I needed to quickly figure out how to work with my child therapy clients.

Thankfully, I found my answer in the form of play therapy.

First, What Is Play Therapy and What’s Its Purpose?

Play therapy is a therapeutic modality meeting children at their level to bring about change and healing.

Rather than expecting children to verbally engage in sessions, to resolve their presenting problems and discuss coping strategies, the act of play can achieve the same results.
Play therapy, as defined by the Association for Play Therapy (APT), can “help clients prevent or resolve psychosocial difficulties and achieve optimal growth and development.”

Why Do Kids Need Play Therapy?

Play is the most natural form of communication for a child.

We can witness it every day in schools and on playgrounds.

No one has to teach a child to play–they simply do it.

Play allows children to express their feelings, build social skills, and relieve stress. It lets them show and respond to what they’ve experienced, such as family dynamics, cultural values, and roles.

During a session, child clients can play out major events, such as parents’ divorce or the birth of a new sibling, using doll families and houses, baby dolls, and toy animals. Play is the “language” which children use, while toys are their “words” (Landreth, 2012).

What Age Is Appropriate for Play Therapy?

Play therapy is most appropriate for children between the ages of three and twelve.

However, it can also be used with adolescents and adults as a fresh intervention or to address presenting problems which stem from childhood.

What Issues Can Play Therapy Be Used to Treat?

Play therapy is effective in treating disorders, like depression, anxiety, and ADHD, as well as helping with learning and physical disabilities.

Additionally, it’s useful in addressing conduct disorders and autism and helping to manage behavioral problems that commonly result from divorce, grief, trauma, and anger (APT, 2022).

Recognized as an evidence-based practice, play therapy (Ray & McCullough, 2016) and Registered Play Therapists (RPTs) can be found worldwide (Directory-Association for Play Therapy, 2022).

Examples of Toys Used for Play Therapy

RPTs take great care in selecting toys for play therapy. All the toys chosen serve a therapeutic purpose.

Some particular play therapy toys allow children to use their creativity and imagination and to express different emotions (Landreth, 2012). Specific toys serving these purposes include dress-up clothing, paints with easels, building blocks, and puppets.

Toys used in play therapy can also provide opportunities for children to learn self-control and independence (Landreth, 2012). Specific toys that help in building these skills include cash registers (figuring out how to open the register drawer), play dough (opening the lid), and Bobo, a small punching bag inflated with air (releasing physical aggression and making adjustments as the bag returns to standing position).

How to Set Up a Play Therapy Room

Play therapists’ rooms are also starkly different from traditional therapists’ offices.

Children are the focus, so it makes sense that they must be able to access all items in a play therapy room.

Design and furnish standard play therapy rooms with children’s heights and arm-lengths in mind. Place all toys on low shelves, and organize them neatly into baskets or bins. Be sure to provide space for a child to play with multiple toys at once, and even to play with toys away from the therapist.

Our goal is to keep the room clean and predictable. After each play therapy session, we “reset” the room so toys can be found in their assigned places by the next child.

What Does a Play Therapist Do During Sessions?

As can be expected, play therapy sessions look quite different from talk therapy with adult clients.

During sessions, we may remain in our chairs (a low-seated rolling chair is best, in order to follow the child around the room) or sit on the floor.

In both situations, we’re lowering ourselves to the child’s level, which helps establish rapport and provides us with a better view for assessment.

Though sessions may last longer, most of my play therapy sessions last between 40-50 minutes. The time length depends on a child’s attention span, energy level, and the time it will take to clean up the room for my next client.

While using play therapy, we use skills to engage the child, such as tracking their activity and reflecting their nonverbals.

Tracking the child’s activity happens when we make a verbal observation of what they’re doing: “You’re building something,” “You’re moving that piece,” “You’re choosing something new.”

Reflecting the child’s nonverbals occurs when we name an emotion they are presenting: “You’re smiling because you’re happy!” “You’re angry that the tower just fell over.”

Both these skills ensure the child knows we are with them, and we’re not just taking notes about what they’re doing. We want to make sure they know we are interested in their play (Landreth, 2012).

Similar to paraphrasing with adults, we reflect child clients’ verbal content.

This occurs when we use children’s own words, match their tone of voice, and mirror their facial expressions.

These responses help children to name their feelings, while helping us maintain connection with them (Landreth, 2012).

We also facilitate decision-making by returning responsibility to the child.

Depending on the circumstance, we may tell the child who asks us for a toy, “You can reach that.” Or, if the child asks us what they should do next, we may respond, “This time, you can choose.”

Most children are used to adults doing basic tasks for them, like retrieving toys, opening lids, and cleaning up.

When we hold children responsible for completing achievable actions, we express our confidence in them. This in turn increases their self-confidence and sense of independence (Landreth, 2012).

Final Thoughts on Play Therapy

As with all treatments, the number of sessions needed will vary based on the client’s needs.

An advantage of play therapy over other modalities, though, is its satisfaction of the client’s interest at the outset.

After working as a play therapist for the past eight years, I’ve yet to meet a child who didn’t want to play during their session.

Play therapy offers children the chance to express themselves in the way that is most natural to them.

When therapists humbly meet children at their level, they create more opportunities for change and healing.

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