Filial Therapy: Treating Social, Emotional, And Behavioral Concerns In Children

Medically reviewed by Nikki Ciletti, M.Ed, LPC
Updated March 1, 2023by BetterHelp Editorial Team

While many types of counseling center around the interactions between therapists and clients, filial therapy is a form of child-centered play therapy that focuses on the relationship between a child and their parents or guardians.

During filial therapy, therapists instruct parents on how to interact with their children and then oversee sessions where the parent(s) and child play. As the children play with their parents, they may develop a stronger attachment and a healthier relationship.

What Is Filial Play Therapy?

Research into this therapeutic method comments that filial play therapy is “a short-term intervention that incorporates a combination of play therapy and family therapy,” overseen by a therapist. In essence, Filial Play Therapy can be used to help children and families in crisis and prevent undesirable behaviors from reoccurring in the future.

While this child-centered play therapy technique was developed in the 1960s, research since that time has shown it to be an effective strategy for improving family relationships as well as effectively treating mental health conditions in younger children such as ADHD and certain anxiety disorders.

What Disorders And Issues Can Filial Therapy Help Treat?

Filial therapy was originally developed to help treat social, emotional, and behavioral issues in children. Its application has since been widened, however, with the theories and practices of filial therapy being applied to many different issues facing children. However, filial therapy not only aims to help children but also their caregivers.

Are You Experiencing Stress Related To Parenting?

Some of the conditions filial therapy can help with include:

  • Anxiety
  • Depression
  • Oppositional defiant disorder (ODD)
  • Aggression disorders
  • Inattention and hyperactivity including attention deficit hyperactivity disorder (ADHD) and its subcategories
  • Attachment issues
  • Trauma including post-traumatic stress disorder (PTSD)

If you are facing or witnessing abuse of any kind, the National Domestic Violence Hotline is available. Call 1-800-799-SAFE (7233) or Text "START" to 88788. You can also use the online chat.

Explaining The Age Limits For Use

Filial therapy aims to help children ages three to 12 through the use of play and imagination. The counseling may prove ineffective for children younger than three years old since they typically have not yet begun to engage in imaginative play. Children over the age of 12, may no longer be able to engage in the kind of imaginative play where they freely express themselves. Teenagers are often best helped by taking a verbal approach to their counseling rather than filial therapy or a similar related form of play therapy.

How Does Filial Therapy Work On Children?

Filial therapy is very different from most other forms of play counseling. In most types of closely related forms of traditional play therapy, a counselor will meet the parents first. At that time, the child's developmental, behavioral, and learning issues, as well as the parent or guardian's involvement and parental techniques, will be discussed.

After that, the therapist will work with the child in play therapy treatment over a matter of weeks or months during individual play sessions.

Although parents receive regular progress reports, they are rarely directly involved in those therapy sessions, though communication between the child and parents about the counseling sessions is encouraged.

In filial therapy, however, the parents are present during every session and will even run most of the sessions themselves. In the first few sessions, the counselor will instruct them on how to complete interactive play and also demonstrate how to engage in mindful play with their child. The counselor will also guide the parents/caregivers in effective parenting methods and basic play practices. After the first few play sessions, the parents will take the therapist’s place and the therapist will assume the role of quiet observer and coach.

The general steps of filial play therapy are as follows:

  1. The therapist provides the parents with a detailed explanation of filial therapy—what it entails, the research behind it, and what it sets out to achieve. During this process, they take any cultural perspectives into account and provide culturally sensitive intervention.
  2. The counselor engages in mindful play with the child while the parents observe the basic steps and the skills that are carried out.
  3. Parents take charge of a play session as the counselor supervises their progress. After the session, the counselor provides feedback.
  4. The sessions are conducted with one parent and one child at a time since each parent-child relationship is unique.
  5. The sessions are moved to the family home, but the parents still have the opportunity to visit or talk with the counselor to discuss their concerns.

Parents may also choose to join a support group to give and receive encouragement as the family continues to work through the issues they face.

The entire therapy process normally includes 15 to 20 sessions of one hour each. This process can take anywhere from three to six months, but may last longer depending on whether or not the family wishes to have follow-up sessions with the therapist. The counseling may also be conducted in a group setting or an individual setting.

Filial therapy may be paired with other types of interventions, typically using other professional psychology and adolescent psychiatric care approaches.

Just as with other forms of play counseling, the counselor and parents will have regular meetings throughout the counseling. This allows them to assess the progress being made and to address any challenges or concerns. They may also discuss themes or patterns of behavior that become evident during the family's sessions. It cannot be overemphasized that the entire point, purpose, and focus of filial therapy is to promote the growth of all involved and to strengthen familial relationships.

Benefits Of Group Filial Therapy

Although this type of therapy is now often used with single families, the original creators began using it as group counseling sessions that involved groups of unrelated families seeking therapeutic change. It is still practiced in this way in some instances.

During group sessions, each caregiver directly works with and focuses on their child, but they also gain emotional support from being among other parents who are learning the techniques with their children. They can see how other caregivers directly employ the techniques, and play therapy activities, and may be better able to evaluate their attempts. Parents also benefit from being able to give and receive constructive feedback within the group.

Techniques Taught In Filial Therapy

While parents are in charge of leading filial therapy sessions, the ease of the techniques used during the sessions relieves any burden the parents might otherwise feel.

The four basic skills taught to parents in filial therapy’s flexible model are:

  • Structuring - The parent sets the stage, so to speak, by identifying the play area and its boundaries. They also decide what toys to include in the play area.
  • Empathic Listening - The parent learns how to be in tune with and reflect the emotions of the child. In other words, the parent discovers how to be more sensitive to the child's emotions and more empathetic when responding to them.
  • Child-Centered Play Therapy: Imaginary Play - The parent watches the child at play and takes part only by following the child's lead. This is called non-directive play or child-centered play. The child is not pushed toward exploring any particular topic—not even the one's parents think may be affecting them the most.
  • Limit Setting - The parent learns to set rules as to what will and will not be accepted during the play session. The rules should be few and not too limiting. For example, displays of aggression should be allowed, within reason.

Social, Emotional, And Behavioral Benefits Of Filial Therapy For Both Children And Parents

Research suggests that filial play may help reduce feelings of depression in children, and decrease child behavior problems.

During nondirective filial therapy, children have a safe and fun outlet to express themselves and communicate with their parents. Likewise, parents can increase their listening skills, which may help them better understand their children. As parents become more attentive and understanding, it can help to establish trust between them and their child. Parents may also develop more confidence in their parenting skills, which can result in an improvement in family relationships.

Within the setting of the child-centered play area, the child feels empowered to explore feelings they may not otherwise express. The parents get the opportunity to see and understand the underlying emotions which might be driving the child's behavior in nondirective play sessions. Allotting this bonding time between each child and each parent gives parents the chance to pay special attention to a specific child and gain empathetic listening skills. This can boost the child's self-esteem, reduce any troubling behavior, and better the relationship between the child and parents.

Filial therapy also allows the parents to learn how to handle frustrating situations by utilizing the parenting techniques they learned from therapists in earlier sessions.

Are You Experiencing Stress Related To Parenting?

Online Therapy As An Option

Filial therapy isn’t the only option to help parents who are coping with doubts or issues related to parenting. If you find yourself overburdened or doubtful due to your role as a parent, you may benefit from discussing your concerns with a licensed therapist. Online therapy through a service like BetterHelp makes it easy to connect with a therapist from your home, so you can sneak a session in while your child is at school or taking a nap.

A literature review found that the effectiveness of online therapy was similar to that of traditional in-person therapy for a wide range of conditions. The results suggest virtual therapy may help parents facing challenges including inter-relationship difficulties with their children and spouses, as well as their choice of parenting style.


Filial therapy is a type of play therapy that focuses on the relationship between parent and child. It may help you better connect with your child and also help overcome relationship struggles. While it won’t solve problems immediately, it may help you improve your family life over time.

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