Sand Tray Therapy

Medically reviewed by Dr. Jerry Crimmins, PsyD, LP
Updated June 20, 2024by BetterHelp Editorial Team
Content warning: Please be advised, the below article might mention trauma-related topics that include abuse which could be triggering to the reader. If you or someone you love is experiencing abuse, contact the Domestic Violence Hotline at 1-800-799-SAFE (7233). Support is available 24/7. Please also see our Get Help Now page for more immediate resources.

Sand tray therapy is a therapeutic approach that may make it easier for people to discuss difficult topics. Particularly for individuals with anxiety, experiences of trauma, or difficulty verbalizing feelings, the introduction of sand play into therapy sessions can provide several benefits to relieve psychological distress and help people cope.

During sand tray therapy sessions, you don’t need to make direct eye contact with your counselor, and the act of playing in a tray and miniature objects itself can help reduce symptoms of anxiety and fear. A therapist can help you determine if this form of therapy may be productive for your situation and needs.

Feeling closed off during therapy sessions?

What is sand tray therapy?

When you’re engaging directly with the environment, you may be practicing mindfulness and body awareness, which can reduce symptoms of anxiety, fear, and anger. Sand tray therapy builds upon this concept, providing a comforting setting to communicate both verbally and non-verbally. It can be a particularly effective modality for children and people who have experienced trauma, but many people can benefit from this form of therapy. 

During sessions, your therapist may encourage you to freely engage in sand play, or they may direct you to use toys to design a scene that represents safety. Sand tray incorporates various theoretical orientations, such as a humanistic approach, whereas a therapist works with sand play therapy by primarily drawing on Jungian psychology.

Either way, the goal of this is to help you overcome obstacles to self-expression.

Play therapy using the sand tray

As an expressive play therapy technique that can be adapted for children, as well as teens and adults, there are two primary types of this methodology: directive, and non-directive. In directive sand play, the therapist will provide questions and prompts for the person engaging in counseling. In non-directive sand play, the therapist will remain silent, and allows the individual to express themselves in a safe space with their sand play tray without being guided by specific questions from the counselor.

The most common way to conduct this is directive and uses the “world technique.” This technique of sand tray therapy was designed by Dr. Margaret Lowenfeld, born from her frustration with traditional therapy, which she found too constrictive and time-consuming for children.  

When using the world technique, your therapist may provide you with a sandbox and miniature toys and figures and ask you to build and create scenes of your inner “safe world” while the therapist observes. Typically, therapists observes quietly during this time, allowing the client to lead their experience with sand trays. While focusing on the client's inner world as represented in the tray,  interpretation and processing by the therapist may take place during the client's world-building process in the tray. 

The International Association For Sandtray Therapy provides the credentials for therapists to conduct sand tray therapy sessions. 

Sand tray & play therapy

A Jungian analyst named Dora Kalff further developed this therapeutic technique after studying with Margaret Lowenfeld, serving as an influence for sandplay therapists today. The International Society for Sandplay Therapy is founded on the principles of Kalff's Jungian background, which encourages the imaginative creation of sand pictures within "a free and guarded space." Drawing on Jungian emphasis on symbols, it uses no directives in the tray. 

Common techniques include imaginary play with toys and figures to help represent, through symbols, the person's inner world. 

Studies indicate that children with behavioral problems who have shown limited response to other interventions may respond well to this approach. 
Creative therapy

Other forms of creative therapy have also been found useful for addressing trauma. Peer reviewed studies suggest that creative arts-based therapy, such as art therapy, can reduce PTSD symptoms in children and adolescents by helping them externalize traumatic events without relying on words alone. 


Who can benefit from sand tray therapy?

Many people can benefit from sand tray therapy, especially children or adults who have experiences with: 

  • Anxiety
  • Post-traumatic stress disorder (PTSD)
  • Autism spectrum disorder
  • Depression
  • Grief
  • Sexual abuse
  • Learning differences
  • Physical disabilities 

Additionally, this can be a helpful strategy for people who have experienced neglect, trauma, or abuse. These situations create strong emotions that may be challenging to discuss, and children may not have the knowledge necessary to describe or recognize the trauma they have experienced. Further, they may not have the words to verbalize it. Child psychology along tactile therapy offered by sand tray therapy can help provide emotional release and facilitate the healing process.

Engagement in creative processes is shown to be an active agent in improving moods, emotional states, and physiological health in children. Additionally, creativity may aid children who have experienced trauma or abuse in processing negative life events. 

Sand tray therapy can allow children a space to express their inner world when feelings are difficult to communicate directly. Additionally, building a world or scene can give children a sense of power and agency over their life experiences. A 2007 study found that this approach, when provided to preschool-aged children, helped them explore their emotions and experiences with post-traumatic stress disorder after surviving the 2004 Indian Ocean tsunami.

Autistic children

Some studies suggest that sand tray therapy can increase the level of language expression and engagement in social situations for children with autism spectrum disorder. By creating pictures, they can use the sand to give insight into their own inner world. Utilization of the world technique can help some children process or express experiences of trauma, even if they do not utilize verbal communication. 

Sand tray therapy for adults

Studies show that sand tray therapy can be therapeutic for adults with symptoms of post-traumatic stress disorder. Some adults, however, may find that the process of engaging in play during therapy can cause discomfort, such as heightened self-consciousness stemming from a belief that they lack creativity. For these adults, other mindfulness-based interventions or talk therapy options with a mental health professional may provide greater benefits for inducing relaxation. 

Couples and families

Within the context of couples counseling, sandplay can be an effective tool to improve skills in nonverbal communication and cooperation. Families, too, may find that sand tray therapy can aid in building stronger connections, and it can be a useful tool for therapists to gain insight into how families collaborate throughout the process. 

Feeling closed off during therapy sessions?

Sand tray therapy benefits

Sand tray therapy can help some people:

  • Reduce symptoms of anxiety and post-traumatic stress
  • Discuss challenges without the use of verbal communication
  • Improve self-confidence and creativity
  • Introduce concepts of mindfulness
  • Process grief and trauma

Sand tray therapy can be a helpful tool for people of various ages who have been sexually abused or experienced other trauma, or are experiencing grief, mental illness, physical challenges, and other disorders. If you are unsure how to talk about a traumatic experience in your life, or if you’re thinking about incorporating sand tray therapy into your routine, you can reach out to a licensed therapist. 

If you’ve experienced trauma in your life, you may benefit from a specific type of counseling called trauma-focused cognitive behavioral therapy (TF-CBT). TF-CBT can be given in a family-based setting for children, where it is shown to improve symptoms of post-traumatic stress disorder, depression, and anxiety. 

Online therapy with BetterHelp

If you’re navigating issues in your life that you believe could be improved through therapy, you may consider using a platform like BetterHelp. BetterHelp is an online counseling medium that you can use to connect with a trauma-informed therapist. The online format of sessions enables you to seek counseling from mental health professionals in the comfort of your own home, and you may find that it’s easier to discuss challenging topics when you are physically distant from your therapist. 

The effectiveness of online therapy

Just like sand therapy can improve someone’s degree of openness and self-exposure, online counseling can have the same effect. For adults, studies support that online CBT is just as effective as in-person CBT for individuals with symptoms of depression, panic disorder, and post-traumatic stress. Online-based treatments such as these can help individuals process their trauma in a safe environment.

Sand tray therapists use a hands-on therapy technique that can be delivered with minimal structure. A humanistic approach, this therapeutic process can provide benefits for a variety of people with mental health challenges, autism spectrum disorder, physical differences, speech difficulties, or traumatic experiences. Sand play in a guarded space can help some people practice mindfulness and reduce symptoms of stress and anxiety while discussing difficult topics. An online therapist can provide you with cognitive behavioral therapy sessions to address symptoms of depression or post-traumatic stress disorder, and you can inquire with your therapist whether they think sand tray therapy may be a helpful technique for you.  

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