Play Therapy

What is Play Therapy?

Play therapy is defined: “the systematic use of a
theoretical model to establish an interpersonal process
wherein trained play therapists use the therapeutic
powers of play to help clients prevent or resolve
psychosocial difficulties and achieve optimal growth
and development”.
This indicates that play therapy is a therapeutic
modality firmly grounded in theoretical models.
Importance of Play Therapy
The therapeutic powers of play can be classified into eight
broad categories: communication, emotional regulation,
relationship enhancement, moral judgment, stress
management, ego boosting, preparation for life, and self-
actualization.
 Play has many benefits in life, regardless of age.
Play is fun, educational, creative, and stress relieving and
encourages positive social interactions and
communication.
When playing, children learn to tolerate frustration,
regulate their emotions, and excel at a task that is inborn.
 Importance of Play Therapy
Children can practice new skills in a way that makes sense to
them, without the structured confines of “the real world” or
the need to use verbal language.
There are no mistakes too big to overcome through play, and
no challenges too tricky to attempt.
Play gives children a chance to master their worlds as they
create, develop, and maintain their own senses of self.
Children use play to communicate when they do not have the
words to share their needs and look to adults to understand
their language.
As Landreth (2002) rightly pointed out, play is a child’s
language and toys are the words.
History Of Play Therapy
Sigmund Freud, through his work with Little Hans,
first brought the idea of therapeutic play into the
practice of psychotherapy.
Freud wrote that play serves three main functions:
promotion of freer self-expression (especially of
instincts considered taboo), wish fulfillment, and
mastery of traumatic events.
To master traumatic events through play, a child
rebuilds the event with a sense of power and control of
the situation.
History Of Play Therapy
Melanie Klein continued the idea of using play for child
therapy in a psychoanalytic framework.
In particular, she believed that play allowed unconscious
material to surface, and the therapist could then interpret
the repressed wishes and conflicts to help the child
understand his or her problems and needs.
Klein agreed with the gradual approach to understanding
and assimilating negative experiences as well as the need
to relive and master such experiences through play.
She worked with younger children than traditional
psychoanalysts would see.
History Of Play Therapy
One technique that Klein (1955) pioneered involved
the use of s.
When children play with miniature toys, they often
feel a sense of control over these objects as the
representation of real-world objects or people.
Margaret Lowenfeld took this idea further and
developed the World Technique.
This technique involves a sand tray and access to water
and miniature objects that represent larger scale
items.
History Of Play Therapy
Sandplay therapists typically have a wide selection of
miniatures available, for example, people, animals,
buildings, landscape items, methods of transportation,
archetypes, and supernatural beings.
In the World Technique, children are given the opportunity
to create an imaginary world in which they can express
whatever they desire.
Children may develop realistic or fantastic worlds, peaceful
or aggressive worlds, orderly or confused worlds.
 These sand trays are considered to be expressions of
predominantly unconscious material and utilized as such
in therapy.
History Of Play Therapy
Another psychoanalyst who used play therapeutically
was Anna Freud (1946).
She helped to bring child therapy, particularly child
analysis, into a more widely used arena.
She believed play was important because it enabled
the therapist to establish a therapeutic alliance with
the child.
Similarly, recent research has suggested that a strong
therapeutic relationship is necessary in every therapy.
History Of Play Therapy
In the middle of the 20th century, Virginia Axline
brought a more humanistic, person-centered approach
to child and play therapy.
In particular, Axline (1947) advocated the belief that
the necessary conditions for therapeutic change were
unconditional positive regard, empathic
understanding, and genuineness.
She also stated that children are better able to express
their thoughts, feelings, and wishes through play than
with words.
Implementing Play Therapy
Like traditional talk therapy, play therapy can be
implemented in a variety of formats.
Child-centered play therapists tend to utilize individual
sessions with the child and allow the child the freedom to
express himself or herself with little direction from the
therapist.
The role of the therapist is to encourage the child’s
appropriate expression of emotions and give the child a
sense of control over the therapeutic relationship.
Therapists who utilize other modalities, such as cognitive-
behavioral play therapy, often structure the therapeutic
process more, depending on the assessed needs of the child
Implementing Play Therapy
Filial therapists train parents to be co-therapists and
implement the therapeutic process through parent–
child interactions.
Filial therapy sessions are similar to client-centered play
therapy ones, but in the sessions the parents encourage
positive interactions that will persevere beyond the
constraints of the therapy room.
Family play therapy that utilizes other modalities (such
as cognitive-behavioral or group approaches) to
encourage involvement of caregivers has also been
shown to be effective.
Implementing Play Therapy
Group play therapy has been applied to a number of
presenting problems.
Therapy groups may be either nondirective or
directive in nature.
In directive groups, sessions are typically psychosocial
in nature and focus on a presenting issue that the
children share in common, such as social skills
deficits, acting out behaviors, or past trauma.
Applications Of Play Therapy
Play therapy clients can be infants/toddlers
preschoolers, or elementary and high school students.
 Clients can come from many socioeconomic
backgrounds, including those who are homeless.
Play therapy can also be utilized with adult and elderly
clients.
While play therapy with adolescents and adults is
continuing to gain popularity, most current
therapeutic interactions are with children ages 3 to 12.
Applications Of Play Therapy
Play therapy is a modality that can be truly flexible in
its location.
The space can be an outpatient clinic or office setting,
a school, a home, the scene of a disaster, a hospital
bed, or a playground.
Play therapy can take place in a fully stocked playroom
or with materials pulled out of a suitcase.
Play therapy is limited only by the extent of the
therapist’s flexibility and creativity.
Playroom & Suggested Materials
Playrooms vary greatly, depending on the setting of
therapy and the therapist’s needs and style.
Theoretical orientation and type of therapy also
contribute to the design of the play space.
For example, therapists using Thera play or group play
therapy require a good amount of clear, open floor
space.
Landreth (2002) has described ideal features of a
playroom to be used for individual therapy sessions.
Playroom & Suggested Materials
He suggests 150 to 200 square feet of space; easily
cleaned materials, furniture, and floors; shelves for
toys and cabinets for extra supplies; a sink with
running cold water; child- and adult-sized furniture; a
desk or table for artwork; a marker or chalk board; and
an attached bathroom.
In terms of play materials, the selection of toys and
other items to be included certainly varies, depending
on the therapist’s theoretical orientation, personal
ideas and values, and budget/space issues.
Playroom & Suggested Materials
There is a selection of basic items that are consistently
useful.
These include the following: animal families, baby
doll, dishes/plastic silverware, doll families, doll house
or box with furniture, puppets, toy soldiers, blocks and
other building materials, clay, art supplies (markers,
large paper, tape, blunt scissors), small pounding
hammer, two telephones or cell phones, doctor’s kit,
small soft ball, playing cards, small box with lid, and
transportation toys (cars, airplane, ambulance, etc.).
 Playroom & Suggested Materials
In addition to these items, such items as masks, mirrors,
rope, dinosaurs, plastic tools, cardboard bricks, books,
board games, dress-up clothes, and a sand tray and
miniatures can also be beneficial.
Another useful feature of a playroom is separation of space.
This might be achieved by variations in floor coverings,
such as vinyl flooring near water or sand areas and
carpets/area mats in other spaces.
Most play therapists like to separate materials by function
to include a designated area for dollhouse play, another for
sand trays, a third for puppets, and so on.
 How To Begin And End A Session
While the process of play therapy is often natural to
children, few parents know what to expect when they bring
their child for individual play therapy.
It is helpful to meet with parents without the child present
to discuss presenting concerns as well as introduce parents
to play therapy.
An explanation to parents that children often cannot use
words to express their feelings and problems and instead
use play is usually well understood.
Play therapy can then be described as a way to learn about
the child’s concerns and problems through play and to help
the child find ways to overcome them.
How To Begin And End A Session
For the child, initial sessions often include an
introduction to the play space and therapeutic process.
Both should be given at the child’s developmental level
and with appropriate amounts of information.
Younger children are often happy to hear that the
playroom is a space for them to play in many ways,
while older children can understand more about the
process.
The amount of information given to a child is also
dependent on the theoretical orientation of the
therapist.
How To Begin And End A Session
Children use the initial session to explore not only the
play space but the therapist as well.
Play therapists should generally allow the child to
explore at his or her own pace and not give suggestions
about which materials to use.
During the first session, therapists should focus on
developing rapport by creating a warm, comforting,
safe environment for the child.
When ending a session, play therapists must decide
whether a child will help pick up the toys or not.
 How To Begin And End A Session
This is a personal and theoretically oriented decision.
Nondirective therapists would not encourage children to
pick up the playroom.
Instead, they gave a warning 5 minutes before the end of
session so that the child can mentally prepare to leave.
For most children, announcing when 5 minutes remain is
sufficient.
Some children require more time to put themselves back
together mentally and would benefit from a 10-minute
warning followed by a 5-minute warning.
This is something that is often dependent on the child’s age
and level of functioning.
Limit Setting In Play Therapy
Although limits on a child’s behavior in the playroom are
generally kept to a minimum, they are needed on occasion for
two main reasons:
 first to ensure the physical safety of the child and the
therapist
Secondly to prevent the destruction of the play materials and
the playroom.
Typically, play therapists do not state the limits in advance
but only as the need arises.
Thus, a play therapist might begin a session by saying to the
child: “You can play with whatever you like in here! If there is
anything you can’t do, I’ll let you know.”
 Limit Setting In Play Therapy
In stating a limit, play therapist recommended the following four-
step procedure.
First, help the child express his or her feelings or wishes
underlying the misbehavior (“You’re angry at me because you
can’t take the toy home”).
Next, clearly and firmly state the limit (I’m not for hitting!”).
 Third, try to point out an acceptable alternative to the
inappropriate behavior (“You can hit this sand to get your anger
out”).
Finally, enforce the limit as needed (“We have to end the play now
because you still want to hit”).
This procedure avoids the extremes of being too harsh or too soft
Limit Setting In Play Therapy
Limits are most often set on acts of physical aggression
(either to therapist or materials), unsafe behaviors, and
socially unacceptable behaviors (including
inappropriate displays of affection).
Limits should also be set when a child tries to take a toy
from the playroom, as well as when engaging in
disruptive behaviors such as continuing to play past the
end of session or trying to leave early.
Limits are often initially uncomfortable for play
therapists to apply, but one can become skilled at it with
practice and patience.
Including Parents And Caregivers
There is growing evidence that including parents in the
therapeutic process is beneficial (Bratton et al., 2005).
Therapists utilizing family play therapy models such as
filial, parent–child interaction therapy train caregivers
to be directly involved as co-therapists to their children.
In the beginning stages of these therapies, play
therapists teach caregivers how to use play interactions
with their children to foster a more positive
relationship.
Stages Of Play Therapy
There are three main stages to the therapy process.
The first, rapport building, involves the initial sessions
wherein the child and therapist begin to build a working
relationship.
The therapist is still gathering information about the
child and his or her experiences, and the child is
learning about the play space and process of therapy.
Depending on the therapeutic orientation, these play
sessions are typically supportive in nature and allow the
child time to feel safe and comfortable in the play
sessions.
 Stages Of Play Therapy
The second stage is working through.
This is the lengthiest of the three stages and is where much of
the therapeutic change occurs.
In this stage the therapist selects and applies the most
appropriate change agent(s) inherent in play (e.g., abreaction,
storytelling, a therapeutic relationship.
During the working-through stage, play themes often becoming
apparent and offer a window into the child’s inner world.
Play themes are those topics that reappear across play sessions.
They may stem from unmet needs/desires, unresolved conflicts,
or difficulties the child is trying to master or is struggling to
understand.
Stages Of Play Therapy
Some examples of common play themes are
aggression, attachment, competition, control,
cooperation, traumatic events, death/grief, fears,
fixing something that is broken/damaged, gender,
good versus evil, identity, limit testing, mastery of
developmental tasks, need for approval or nurturance,
power, problem solving, regression, replay of real-life
situations, school, sexuality, social rules, transitions,
vulnerability, and win/lose situations.
The therapeutic use of these themes will depend on
the theoretical orientation of the therapist.
Stages Of Play Therapy
The final stage of play therapy is termination.
The therapist and child have used the therapeutic
process to ameliorate or resolve the presenting
problem(s).
The termination stage is intended to allow the child
and family to take ownership of the changes that have
occurred and to prepare the way to ongoing
improvements.
Characteristics Of Effective Play Therapist
A review of the play therapy training literature
suggests that there are personal characteristics such as
patience, flexibility, and love of children that all
therapists need to work with children.
In regard to the characteristics of a “good” play
therapist, Nalavany and colleagues (2005) found in a
sample of 28 experienced play therapists that they
rated the personal qualities of empathy, warmth, and
genuineness as most essential, while they considered
theoretical knowledge and technical skills to be less
important but easier to acquire.
Characteristics Of Effective Play Therapist
Harris and Landreth (2001) outlined eight of the most
essential characteristics of child-centered play
therapists.
This list includes genuine interest, unconditional
acceptance, and sensitivity to the child.
Their list also includes the ability to create a sense of
safety, to trust a child to lead the course of therapy in a
gradual and natural manner, and to honestly believe
that a child is capable of solving his or her problems
while setting the few necessary limits needed to help a
child in this process.
Toy and Object Play Techniques

Ball Play
For example, in a group therapy session, a therapist might
have a group take turns throwing a ball around, and
anytime someone catches the ball they have to say
something that makes them happy.
Plush Doll Play

For example, the therapist might present the client

with a few stuffed animals (or ask the client to bring
their own) to help comfort the child during a therapy
session.
Medical Play

For example, a client who has just undergone a

stressful medical procedure might do a play
examination on one of their stuffed animals, so they
can feel a sense of control.
Alternatively, the client may re-enact or role play
hospital procedures in such a way that they have fun
“doctoring” the therapist.
Baby Doll Play

For example, a therapist might use a baby doll to

model positive, nurturing behaviors for the client, or
might let the client play with the doll to see what the
client’s natures are. If the client starts mistreating the
doll, it is possible that the client is being mistreated by
their own parents.
Baby Bottle Play

This form of play can be valuable for exploring

different familial roles through symbolic play, such as
the role of the carer.
An example is if the client were to fill up and offer the
therapist a bottle as an act of nurturing. This act may
then facilitate discussion about the client’s own
experiences of caring and being cared for.
Toy Telephone Play

For example, the client and the therapist might each

have a toy phone, and the therapist can ask therapy-
related questions on the phone. The client might be
more comfortable indirectly answering questions like
this, and if they feel uncomfortable they can just hang
up.
This indirect form of communication has been shown,
in particular, to help children struggling with elective
mutism.
 Magic Wand Play
For example, the therapist might give the client a
magic wand and tell them they can make three wishes.
At least one of the wishes is likely to relate to a real-life
problem the client has.
This play technique is effective for helping clients to
safely verbalize their wishes or goals, as well as aspects
of their environments (e.g., at school or in their home)
that may be troubling them.
Bubble Play

For example, the therapist might simply let the client

run around blowing bubbles and popping them for
stress relief reasons or to help a child bond with other
children in a group session (Schaeffer & Cangelosi,
2016).
Block Play

For example, the therapist might construct a wall of

building blocks and allow the client to throw a ball to
knock the blocks down. This can help the client
release anger. A variation of this technique, developed
by psychologist Robert Resnick (2002), can support a
pair of clients in strengthening their communication
and listening skills. Both clients have an identical set
of blocks and are concealed from view of each other.
Each then takes turns building a construction out of
their blocks, while verbally directing the other person
to build an identical construction.
Balloon Play

For example, the therapist might ask a group of

children in a group session to keep a balloon up in the
air for as long as possible, to foster bonding, and to
break the ice in a group session (Schaeffer & Cangelosi,
2016).
Tearing Pages Play

For example, the therapist might give the client a

phone book, and ask them to tear pages out of the
book, crumple them up, and throw them into a trash
can. This can help the client understand how to “throw
away” angry feelings (Schaeffer & Cangelosi, 2016).
Sensory Play

For example, the therapist might let the client play

with shaving cream by spreading it around, sculpting
it, and even pretend shaving, so the client can
creatively express themselves and feel more relaxed
and in control (Greenburg, 2003).
 Metaphors and Storytelling
Techniques
Concrete Play Metaphors
For example, a therapist might present dozens of toys
to the client, then ask them to pick out toys that
represent family members. This can help the therapist
see what the client thinks and feels about their family
members (Schaeffer & Cangelosi, 2016).
Turtle Technique
For example, a therapist might give a client a turtle
puppet, and explain that when the turtle is upset
about something it stops, goes into its shell, closes its
eyes, and takes three deep breaths. The client can then
play out this process with the turtle puppet, and this
can help the client learn anger-management
techniques (Schneider & Robin, 1974).
Emotion Thermometer

For example, the client might be presented with an

“emotion thermometer” showing a range of emotions from
0 (with a smiling face) to 10 (with a frowning face) and
asked to list events that make them feel like they are on
different points on the thermometer. This might sound like,
“What types of things make you feel like a smiling face?
What about a frowning face? What about a medium face?”
It has been shown that children who are taught to monitor
and regulate their emotions using this technique are likely
to engage in fewer aggressive and disruptive behaviors and
display improved behavior in the classroom (Wyman et al.,
2010)
Mutual Storytelling
 Developed by child psychiatrist Richard Gardner (1971), this
technique involves the telling of stories by both the client and the
therapist. In this, the client (usually a child aged 8-14) is invited to
tell a made-up story using fictional characters.
 At the end of the story, the child is asked to explain the lesson or
moral of the story, and then the therapist re-tells the story using
the same characters but offering more adaptive solutions to the
conflicts faced by the characters.
 To illustrate, imagine a child patient was to tell a story about two
children fighting over a toy. If the child’s resolution to the story
involved one child using force to take the toy, the therapist’s
adaptive version of the story may depict the two children reaching
an agreement to take turns and share the toy.
Externalization Play

For example, the client and therapist might work

together to create a character that represents one of
the client’s problems, such as a dragon that represents
the client’s fear.
The therapist can then ask questions about the
problem without directly addressing the client’s fear,
by externalizing the problem to the dragon (Schaeffer
& Cangelosi, 2016).
Bibliotherapy

For example, the therapist might find a story or book

that involves a problem similar to the client’s problem,
and that provides a solution to this problem (Schaeffer
& Cangelosi, 2016).
While reading this story with the client, the therapist
might ask questions relating the story to the client’s
life, such as, “Have you ever felt this way?”.
 Role-play Techniques

Role-Play
For example, the therapist and client might role-play a
situation the client is anxious about, such as the first
day of school, so that the child can work out what they
feel anxious about and possibly realize they do not
need to be anxious at all (Schaeffer & Cangelosi, 2016).
Costume Play

For example, the therapist and client might pretend

that the client is being crowned the new king or queen
of a land. The therapist can then ask what the new
king or queen wants to do with their power, to figure
out what the client likes and dislikes (Marcus, 1966).
Mask Play

For example, the therapist might ask the client to

make two collages (masks) out of magazines. One
mask (the “outside mask”) is how they think the world
sees them, and one mask (the “inside mask”) is how
they see themselves. This can reveal a lot about how
the client thinks of themselves and the world
(Schaeffer & Cangelosi, 2016).
Superhero Play

For example, the therapist might ask the client to draw

a superhero with superpowers that the client would
like to have. The therapist can then help the client
figure out how their personal strengths can be as
useful as these superpowers (Rubin & Livesay, 2006).
Puppet Play
Puppets are frequently used tools in play therapy, which can
be employed in a variety of ways (see Drewes & Schaefer,
2018). One popular technique is called the Family Puppet
Interview. When facilitating this form of play, the therapist
will present the client and the client’s family with dozens of
puppets, then ask the client and the client’s family to each
choose a puppet to represent them.
The client and the client’s family then tell a story using the
puppets, and the therapist interviews each family member
about the story then discusses the story with the whole
group. This can reveal certain family dynamics that the
client is unable or unwilling to directly discuss with the
therapist (Irwin & Malloy, 1975).
Communicating through puppets has also been shown to
help clients struggling with elective mutism (Rosenberg &
Creative Arts Techniques

Color Your Life

For example, the therapist and client might work
together to figure out which colors represent which
feelings (such as blue for sad, red for angry, yellow for
happy, etc.).
The therapist can then ask the client to draw a
timeline of their life, using the colors to represent
feelings. The therapist can also ask the client to draw
different aspects of their life, such as school or sports
(O’Connor, 1983).
Clay Play

For example, the therapist might give the client a ball

of clay and let them do whatever they want with it.
Unstructured clay play has been shown to be effective
for relieving stress (Kimport & Robbins, 2012), but it
can also be used to encourage clients to sculpt things
that are important to them or troubling them that they
can talk about with the therapist.
Free Drawings

Free drawing is a widely used play therapy technique

that serves a range of functions (Golomb, 1992). It can
help therapists develop a rapport with new clients,
encourage clients to express their emotions, and reveal
unconscious disturbances that spark discussion.
For example, the therapist might simply give the client
paper and some crayons (or any drawing materials)
and ask them to draw a picture. The therapist can then
ask open-ended questions about the picture once it is
complete.
Mandala Drawings

For example, the therapist might give the client a

mandala template and ask the client to color it in. The
client can then make their own mandala and color in it
if they wish.
This activity can help foster creativity and relaxation
(Schaeffer & Cangelosi, 2016).
Serial Drawings

For example, the therapist might ask the client to draw

a picture (nondirected) every session. After the picture
is drawn, the therapist and client can talk about it,
with the therapist not taking notes so it is clear they
are present. These drawings over time might show the
client’s state of mind as the therapy process progresses
(Schaeffer & Cangelosi, 2016).
Collage

For example, the therapist might ask the client to

collage a nightmare they have been having on the
inside and outside of the box. The client can then play
with the box to become less scared of it.
Collages can be a great medium of expression for
clients who don’t consider themselves artistic and
perhaps shy away from painting or drawing (Schaeffer
& Cangelosi, 2016).
Painting

Similar to free drawings, the therapist might ask the

client to finger paint whatever they want, after which
the therapist can ask the client to tell a story about the
painting (Schaeffer & Cangelosi, 2016).
Trauma Drawings

For example, the therapist might ask the client to draw

a traumatic experience in the client’s past, such as an
earthquake. Research has shown that the act of then
crumpling up the paper and throwing it away can
invoke a sense of control over the traumatic event and
be therapeutic for the client (Pynoos & Eth, 1986).
Dance/Movement Play

For example, the therapist might have a client simply

play with a hula hoop, so that they focus and relax,
which might put them in a better state of mind for a
therapy session. This technique can also help clients to
integrate facets of the mind and body (Krueger &
Schofield, 1986).
Draw a Family

For example, the therapist might ask the client to draw

a picture of their family. Once the picture is drawn, the
therapist can ask which drawing is which member of
the client’s family and discuss whatever the client
wants to discuss about the drawing.
The ways various family members are drawn can be
revealing and has particularly been shown to help
elucidate clients’ experiences of a blended family
environment (Berger, 1995).
Family Sculpting

Similar to the Draw a Family technique, the therapist

might ask the client to use clay to sculpt their family
members, including the client themselves. Once each
family member has a clay figure, the therapist might
ask the client to place them in relationship to each
other, which can show the therapist how close or far
from each family member the client feels themselves
to be.
Musical Play

For example, the therapist might present the client

with a number of toy instruments and simply ask the
client to make up a song or play along with another
song. This can help the client express themselves,
build self-esteem, and improve the therapist-client
relationship (Moreno, 1985).
Imagery and Fantasy Techniques


Guided Imagery
For example, a therapist might ask the client about a
nightmare they have been having, then explain to the
client that nightmares are like movies, and tell the client
that they can change the nightmare if they do not like it.
The therapist can then work with the client to figure out
a happier ending for a nightmare, in an attempt to
retrain the client’s brain to feel more control (Kaduson
& Schaefer, 2003).
For example, the therapist might give the client a tray
half-filled with sand, and dozens of toys, including
people, fantasy figures, and scenery. The therapist
then allows the client to build their own world without
providing any guidance or judgment. The therapist
then asks the client questions about the world, still
without providing any guidance.
The idea is that the world the client builds might
involve themes the client deals with in real life so that
the world can be an opportunity to work through some
of these issues (Hutton, 2004).
Dollhouse Play

For example, the therapist might give the client a

dollhouse and some dolls representing their family
members. The therapist can then ask the client to
model four different everyday scenarios in their real
house: bedtime, dinnertime, playtime, and clean up
time, to figure out more of the client’s family dynamics
(Warren et al., 1996).
Adaptive Doll Play

For example, the therapist might give the client a few

dolls to represent themselves and their family
members and ask them to play out a scenario that is
similar to a real problem the client is having. The
therapist can then help the client figure out ways the
client can respond to these scenarios so that they have
more positive outcomes.
Evidencing the efficacy of this play technique, one
case study found that adaptive doll play reduced
clinging behaviors, crying, and children’s requests to
call home while at school (Danger, 2003).
Rosebush Fantasy Technique

In this technique, the therapist asks the client to close

their eyes, imagine that they are a rosebush, and
describe this rosebush, including where it is, who
cares for it, and any roots, thorns, or flowers it might
have.
The client can then draw the rosebush and tell its
story to the therapist, at which point the therapist can
ask which parts of the rosebush and its story the client
identifies with. This metaphor of the rosebush can
facilitate communication of the client’s needs,
feelings, and experiences (Stevens, 1971).
Family Relations Technique

For example, the therapist might put a number of

mailboxes in front of the client, one for each family
member and one for “Mr. Nobody”.
The therapist then gives the client “mail”, which consists
of strips of paper that read things like “loves me”, “hates
me”, “protects me”, “hurts me”, and asks the client to put
these pieces of mail in each appropriate mailbox (so if
the client thinks their dad loves them, they would put a
“loves me” paper in their dad’s mailbox).
This can help the therapist further understand family
dynamics (Schaeffer & Cangelosi, 2016).
Worry Dolls

For example, the therapist might give the client a set of

Guatemalan worry dolls (According to legend, Guatemalan
children tell their worries to the Worry Dolls, placing them
under their pillow when they go to bed at night. By morning
the dolls have gifted them with the wisdom and knowledge
to eliminate their worries), or help the client make their own.
The therapist can then ask the client to assign a worry to each of
these dolls, put the dolls in a box, and leave the dolls in the
therapist’s office so that the dolls can worry about the client’s
issues instead of the client having to worry about them.
In future sessions, the therapist can bring these dolls out one-by-
one to discuss these worries and how the client is dealing with
them (Schaeffer & Cangelosi, 2016).
Tea Party Play

For example, the therapist might throw a tea party

celebration for the client, to commemorate progress
the client is making during therapy sessions or
achievements the client has reached outside of
therapy. This positive reinforcement can help raise the
client’s level of self-esteem and strengthen the
relationship between the therapist and the client.
Tea parties can also be a mode to explore themes such
as nurturance and reciprocity (e.g., ensuring to pour
tea for everyone around the table; Ryan & Wilson,
1995).
Game Play Techniques

Communication Games
For example, the therapist and client might play “The
Talking, Feeling, and Doing Game”. A turn of the game
might look like this: the client draws a card that says
“Make believe that something is happening that is
scary. What is happening?” and if the client does what
the card says, they get a chip.
During the game, the therapist can see how the client
reacts in certain situations and advise them on how to
react in these situations (Gardner, 1973).
Self-Control Games

For example, the therapist and client might play

“Simon Says”, where the client has to do what the
therapist says (such as jumping on one foot), but only
if the therapist started their sentence with “Simon
says…”. This can promote paying attention and self-
control, as the client has to pay attention to what the
therapist is saying and only do what the therapist says
in certain situations (Schaeffer & Cangelosi, 2016).
Strategy Games
For example, the therapist might simply play a familiar
strategy game with the client, such as chess, ball, or
pick up sticks. This can help the client focus and feel
happier, as well as foster a bond between the client and
therapist. These games can be especially useful during
early therapy sessions if the client is uncomfortable
with the therapist or the idea of therapy itself.
These games may help a client feel a sense of control
and mastery or strengthen impulse control and self-
regulation in their efforts to master the game. The
chess pieces may also be seen as embodying parental
symbols and, therefore, help spark conversation
regarding family members (Fried, 1992).
Cooperative Games

For example, the therapist might play a cooperative

game with the client, such as a game like Max the Cat,
where players have to help a mouse, bird, and
chipmunk get home before Max the cat eats them.
Playing cooperative games like this can help the
therapist-client relationship or the client’s relationship
with family members who are also participating in
therapy. It can also help the client build social skills,
especially if they have trouble working together with
their peers (Guttentag & Alex, 1997).
Chance Games

For example, the therapist might play a game with the

client that is mostly determined by chance, such as the
board game Candy Land or the card games War and
Go Fish. These games are familiar and can help the
client ease into a therapy session, as well as help the
client build a relationship with their therapist.
Since these games are mostly determined by chance,
they also offer the client an opportunity to cope with
unexpected losses that they could not have avoided
and give therapists the opportunity to walk the client
through these situations (Schaeffer & Cangelosi, 2016).
Squiggle Game

For example, the therapist might close their eyes and draw
a random squiggle on a piece of paper, then ask the client
if the squiggle looks like anything or makes them think of
anything. The client can then draw their own squiggle and
ask the therapist if they think it looks like anything.
The therapist and client take turns drawing random
squiggles for each other to see if they can find anything in
the squiggles. This game can help the client feel more
comfortable in a therapy session, and can also work as a
sort of Rorschach test for the therapist to find out more
about how the client thinks
Other Techniques

Desensitization Play
For example, a therapist might help a client work
through their fear of the dark by desensitizing them to
darkness.
This might be accomplished by having the client and
their parents play fun games at night in a gradually
darker room so that by the end the client is still having
fun despite being in the dark. This can show the client
that there is nothing to be afraid of (Kelley, 1976).
Laughter Play

For example, the therapist and client might take turns

trying to make each other laugh in any way they can
(without touching each other). The client’s parents
can also play a tickling game with the client for the
sole purpose of making the client laugh.
Laughter causes lower levels of stress and can improve
relationships (Puder, 1998), so either of these options
are useful since an improved parent-child relationship
and an improved client-therapist relationship are both
beneficial.
Reenactment Play

For example, the therapist might recreate a stressful event for

the client, such as a car accident, using toys in the playroom.
The client can then freely play with the toys in a non-directed
manner. This reenactment may help the client to gain a sense
of control over the situation and let go of lingering feelings of
trauma and fear through a process of desensitization.
It may also allow the therapist to strengthen their
understanding of personal meanings associated with the
trauma as it is acted out in the form of a narrative (Schaefer &
Drewes, 2013). According to Schaeffer and Cangelosi (2016),
these reenactments often need to happen multiple times over
multiple sessions for optimal results.
Stress Inoculation Play

For example, the therapist might have the client play

out a future stress-causing situation, such as an
upcoming class presentation. The client can use toys to
work out what might happen during the presentation,
and the client might realize that the situation is not as
scary as it first seemed.
The therapist can also offer coping strategies for the
client based on the client’s fears about the
presentation (Schaefer & Drewes, 2013).
Hide-and-Seek Play

For example, a therapist might create hiding spaces in

the playroom so they can play hide-and-seek with the
client. This game is an avenue through which the
therapist can explore issues such as separation anxiety,
loss, or abandonment (Frankiel, 1993). Of course, it
may also simply serve as a fun activity the therapist
and client can bond over (Schaeffer & Cangelosi, 2016).
Magic Tricks

For example, the therapist might ask the client if they

want to see some magic, show them a magic trick, and
then show the client how to do the magic trick
themselves. This is a fun activity that can help the
bond between the therapist and client. Showing the
client how to do the trick themselves can also give the
client a feeling of control and mastery, which can raise
their levels of self-esteem.
Feeling Faces

For example, the therapist might decorate their

playroom walls with “feeling faces”, or faces that
demonstrate different feelings such as happiness or
anger. The therapist can then start off the therapy
session by asking the client to point to a face that they
identify with at the time, which can give the therapy
session some direction.
They can also be helpful for clients to show how they
are feeling throughout the session without having to
use words (Curry & Frazio-Griffith, 2013).
Suitcase Playroom

For example, a therapist might create a “suitcase

playroom”, which is simply a suitcase filled with the
toys and materials necessary for play therapy. This is
helpful for play therapists who do not have dedicated
playrooms. The play therapist can then open up the
suitcase to start each session and pack it up at the end
of each session.
This is not only practical for smaller therapy spaces,
but also shows the client that the therapist cares for
them since they are going out of their way to bring all
these toys for the client (Schaeffer & Cangelosi, 2016).
Play Therapy Rituals

For example, a therapist might start every session with

the client in the same way, perhaps by saying hello,
asking the client to remove their shoes, and then
starting the squiggle game.
This predictability can show the client that play
therapy is a safe space for them and can raise their
levels of self-esteem and feelings of control. Rituals
can also take place at the end of each therapy session
so that the client knows that every session will end
with a free drawing (Schaeffer & Cangelosi, 2016).
Some of these techniques are designed to help children
reduce their aggression, while others are meant to be
escapist fantasy games. Other techniques on this list
involve representational play, where children can detail
their problems to the therapist without doing so explicitly.
Some are simply meant to help children pay better
attention to aspects of the world around them. This wide
variety of techniques underscores how valuable play
therapy can be to all sorts of children since there is a
technique for just about every type of play a child might
prefer.