Is Play Therapy A Real Thing, And Does It Really Work?

Updated October 5, 2022 by BetterHelp Editorial Team

What do you think of when you hear the phrase "play therapy?" It's easy to understand the general idea that play therapy is some combination of play and talk therapy. You may have even had one or a few experiences with it when you or your child was under the care of a play therapist. However, sometimes, even being a part of the process doesn't help you truly understand what is happening. As in most fields of inquiry, it's best to start with what you know. What we know is that play is an important part of life.

The notion that play can be a valuable form of children's expression and learning and a helpful way for adults to better understand them has been around for a long time. In 1909, Sigmund Freud told a parent to observe his child at play to help him overcome a phobia; this was the first documented use of play therapy as a psychological method.

Since Freud's early use of this therapeutic modality, more and more psychologists have studied and practiced this type of therapy. Play therapy has indeed become a recognized specialty in psychology that is often the first choice of psychologists for their young clients. To understand play therapy takes more than a single, isolated experience. This article explains some of the most important things to know about play therapy as it exists today.

Benefits of Play

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It's Common To See Play Therapy As An Ineffective Treatment

The fact that play benefits people, especially children, can't be overstated. Children use play to develop motor skills, complex thinking, communication skills, social skills, creativity, and much more. They also explore the ways in which people take on roles. They mimic relationships. They try out vocations. They learn about their world. They experiment and gain skills. They also process what happens to them in their daily lives to make sense of it in their own way. They exercise their minds, their bodies, and their emotions as they're engaged in fun activities. As they do all this, they grow into the person they are becoming. Play is the avenue most children take to get there.

What Is Play Therapy?

Play therapy is a therapeutic modality. In other words, it's a type of therapy, plain and simple. Yet, the field of play therapy is far from simple. Play therapists use many different types of play to help their clients solve a wide variety of problems.

The client may play alone or with others. They may play with the therapist or with their own parents or siblings. The therapist observes and speaks with the child to evaluate their physical and/or mental health issues. They then set up a situation that encourages the child to play freely, enthusiastically, and imaginatively. When they interact with the client, they rely on their play therapy training to help them guide the child to discovering insights that can change the way they experience their world.

Through play therapy activities such as playing with sand, engaging with animals, or playing a board game, the play therapist can better understand who the client is at that stage of their life. They use registered play therapy to teach their client helpful life skills that will improve their mental health, as well.

Mental Health Objectives in Play Therapy

Mental health is only one of the uses of play therapy. When a developmentally disabled child plays to build physical life skills, this can be done in play therapy sessions designed especially for them. Adults with brain damage are often given play therapy, playing card games or specially-designed video games, as a part of their rehabilitation. Play therapy for mental health reasons is one of the most efficient ways to deal with mental and emotional problems. It's been proven effective again and again for these types of mental health issues:

  • Physical or sexual abuse
  • Anger management
  • ADHD
  • Anxiety
  • Autism
  • Chronic or terminal illness
  • Conduct disorders
  • Crisis situations
  • Depression
  • Developmental problems or disability
  • Domestic violence
  • Grief
  • Hospitalizations
  • Learning disabilities
  • Natural disasters
  • Parental separation or divorce
  • Recent or past traumas

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.

Who Is Play Therapy For?

While play therapy is used most often with children aged 3-11, it can also be helpful for teenagers, adults and geriatric clients. Recently, play therapists have begun to use this modality for infants and toddlers as well.

Obviously, people of different ages play in different ways. Children typically play more than other people, and they can enjoy most kinds of play. Play for teenagers and adults may include board games, card games, sports, or recreational activities such as hiking or camping. Older adults may be more limited in what they can do physically, and their mental capacity is usually less than it once was. However, they can enjoy games and recreational activities, too. No matter what the age group or type of play, there are play therapists who have experience with it.

Who Provides Play Therapy?

Play therapy is provided by a licensed mental health professional with a Master's or PhD. Beyond their degree in a mental health field, they have training and experience in play therapy. Some play therapists decide to do extra specialized training and get more experience in play therapy under the supervision of someone already in the field to become a Registered Play Therapist.

Who Directs the Play Session?

The therapist is in charge of determining what play therapy techniques to use and what types of play to include, of course. This doesn't mean that the therapist necessarily tells the child what to play with. The therapist, in fact, may allow the child to play on their own, doing whatever they want to do. Other times, the therapist may begin the play. In addition, parents are sometimes involved in the playtimes.

Directive Play Therapy

When play therapy was first used, it was typically the directive approach. The therapist told the child what to play with and asked them questions to evaluate their condition. They then observed and sometimes participated in play with the child, always steering the play and the conversation in the way they wanted it to go. Directive play therapy is still used in certain situations if the play therapist deems it the best option. However, this type of therapy is usually considered outdated. It focuses on pathology and assumes that children are incapable of healing themselves.

Child-Centered Play Therapy

Most play therapy these days is child-centered. This means that the child is the focus of the therapy. They have more options of what to play with, how to play, and what issues they need to address. They make these choices known simply in the process of their play.

Child-centered play therapy is an outgrowth of person-centered therapy. This is a type of therapy that assumes that the client has the drive to become healthier. They also have the means to do it for themselves with limited input from the therapist.

The play therapist's job in child-centered play therapy is to give them unfailing positive regard, empathy, understanding, and a sense of congruity. The child is the one who directs their own play and, in the end, makes the healing happen.

Parents as Facilitators

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Therapists sometimes include parents in play therapy sessions. They may ask the parent to play with the child while they watch from behind a two-way mirror. This allows the parent to interact with the child as they do at home and the therapist to see how the child responds.

The play therapist may also ask the parent to play with their child at home and make specific observations. This homework assignment for the parents not only gives them the opportunity to be an important part of their child's therapy, but it also contributes to their child's healing and maturation.

Adlerian Play Therapy

The Adlerian version of play therapy uses a combination of all three of these. The therapist, the child, or the parent may at different times direct the play experience. The goal is to help the child become more interested in social experiences, gain insights, and learn new skills.

Play Therapy Types

Psychologists who specialize in play therapy have combined play therapy theories with many of the traditional therapy types. Because of this, a part of choosing a play therapist is choosing the type of therapy you want for yourself or your child. The following are a few of the schools of thought that have been put to work by play therapists.

Cognitive-Behavioral Play Therapy

Cognitive-behavioral therapy has long been a go-to for helping adults examine their thoughts and gain more control over them. Since thoughts influence feelings and feelings influence actions, getting familiar with how to manage your thoughts can improve your mental health considerably.

Cognitive-behavioral play therapy takes those concepts and applies them to children at play. The play therapist and child together direct the play session that typically uses play through toy cars, sandboxes, puppets, dolls, or other modes of expressive play. CBPT is considered a psycho-educational therapy, and it is typically a short-term form of structured play therapy.

Dyadic Play Therapy

In dyadic play therapy, two children interact during play. The goal is for children to learn how to make friends.

Ecosystem Play Therapy

Ecosystem play therapy considers the bigger picture of the child's development and the challenges they are facing. These considerations are used to create a treatment plan for the child's play therapy sessions.

Experiential Play Therapy

Experiential play therapy combines child-centered play therapy with relationship therapy.

Empirically-Based/Evidence-Based Play Therapy

This type of play therapy is based on the results of current play therapy research. Therapists rely on recognized scientific outcomes to determine the course of treatment. Considerations for this plan include the individual characteristics of the child, their culture, and their unique likes and dislikes, and how other children with the same factors have fared in different types of play therapy.

Gestalt Play Therapy

In gestalt play therapy, the focus is to help the client be more self-aware, better develop their sense of responsibility, and stay in touch with the here and now.

Group Play Therapy

Therapists use group therapy for two or more children. The children may be siblings or may instead be together often in another type of situation such as an educational setting.

Integrative Play Therapy

Integrative play therapy is simply a form of therapy that takes the wisdom of two or more other types of play therapy and combines them to provide the best possible solution for an individual child.

Jungian Play Therapy

The focus of Jungian play therapy is the inner self of the client. The therapist helps the client identify the symbolism in their fantasy play. The goal is to become more whole as a person.

Object-Relations Play Therapy

This type of therapy is used most often for children with attachment disorders. The focus of the play session is on the relationship between the therapist and the child at play.

Prescriptive Play Therapy

Prescriptive play therapy is just another way of saying that the therapist uses various techniques from multiple branches of play therapy that they deem necessary to help the child meet their own needs.

Psychoanalytic Play Therapy

This type of play therapy borrows from the field of psychoanalysis. The focus is creating a play situation that will cause unconscious thoughts to surface so the therapist can explain the meaning of those thoughts in a way the child can understand.

Psychodynamic Play Therapy

Psychodynamic play therapy deals with both the conscious and unconscious emotional difficulties the child expresses through play. It is usually a shorter-term type of therapy than psychoanalysis.

Relationship Play Therapy

As the therapist demonstrates that they accept, respect, and have faith in the child, the child and therapist develop a positive relationship. This relationship forms the basis of therapy that seeks to resolve emotional difficulties and bring healing.

Specially-Focused Play Therapy Activity Types

So much of a child's life is spent in play, so it isn't surprising that a wide variety of play experiences are used in play therapy. Below is a sampling of some of the types of play therapy activities that have proven effective.

Animal-Assisted Play Therapy

The therapist works with one or more animals in treating a client in this special form of play therapy. The therapist directs the play to a certain extent, and ensures the safety and health of the animal. Interacting with an animal in this type of therapy improves the child's development and mental health.

Art Therapy

Art therapy is used for people of all ages as a separate discipline from play therapy. However, art can be used as a part of play therapy that allows children to develop new skills and the confidence that goes along with them, as well as to freely express their feelings.

Filial Play Therapy

This type of therapy is used for siblings. Another thing that makes filial therapy different from many other types is that the therapist teaches the parent to do child-centered play therapy with their children.

Game Play

Older children, teenagers, and adults often benefit from gameplay therapies. The therapist may observe or interact with clients as they play a board game, card game, or a sport like billiards or bowling. This allows older clients to engage in the activities that they consider to be play for them.

Narrative Play

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It's Common To See Play Therapy As An Ineffective Treatment

Narrative play is basically storytelling. The child may be prompted to tell a story, or the child and the therapist may create a story together. As the story takes shape, the counselor helps the client deal with the difficult emotions and unhealthy thought patterns that come up during this play experience.

Playing with Toys

Probably the most common items used for this type of therapy are play therapy toys. These can include any of the typical toys children play with, such as dolls, toy cars, blocks, etc. They can also include specialty toys designed specifically as play therapy toys.

Sand Play

Sand play is a very popular form of therapy, not only for children but also for people of all ages. Interacting with the sand has a very calming effect, which makes expression happen much more effortlessly. The client may play in a sandbox or simply run their fingers through the sand in a sand tray. Sandplay Therapy typically focuses on the symbolism behind the play, while sand tray therapy helps the client process their experiences with others and within themselves. Jungian therapy is often combined with the sand play modality.

Sensory-Motor Play

In sensory-motor play therapy, the client does activities that engage both their body and their mind.


Trauma-focused cognitive-behavioral play therapy helps clients who have a mental health issue, such as PTSD, because of a trauma. As they play, the client learns coping skills that help them deal with the memories associated with that trauma.

Does Play Therapy Work?

The fact that there are a lot of theories about something and a lot of different ways to do it doesn't necessarily prove that it works. So, your question at this point may be, "Yes, it all sounds good, but does it really work?" The answer is yes, it does work for many clients of all ages. A licensed therapist can tap into the therapeutic powers of play to facilitate a beneficial therapy experience for the client.

Therapeutic Powers of Play

Play therapists refer to the therapeutic powers of play. These are all the different ways that play can benefit the person who plays. Some of these include:

  • Direct or indirect learning
  • Self-expression
  • Improved relationships
  • Forming healthy attachments
  • Releasing negative emotions
  • Reducing stress
  • Solving problems creatively
  • Building self-esteem

Research Outcomes

Numerous research studies have shown time and again how effective play therapy can be. Although certain scholars have condemned this type of therapy as one that hasn't yet been studied adequately, one scholarly review found 93 play therapy controlled-outcome studies to compare and contrast. The therapies that were shown to be most effective in these studies were humanistic ones and/or those that involved the parents in the play therapy.

Individual Outcomes

People, particularly children, who have the chance to engage in play therapy enjoy a variety of benefits. The outcomes of their play therapy might include:

  • They become more responsible.
  • They become more successful in school, on the social scene, or in their careers.
  • They learn how to come up with creative solutions to problems.
  • They come to respect both themselves and others more.
  • They develop a greater ability to experience and express their emotions.
  • They learn or increase their ability to feel empathy and respect for the thoughts and feelings of others.
  • They learn to handle social situations more effectively.
  • They learn healthy ways to interact with other family.
  • They receive positive responses to their abilities and become more self-assured.

How to Become a Play Therapist

If play therapy intrigues you, you might consider becoming a play therapist. It can be not only a lucrative profession with a relatively high salary, but it can also be an enjoyable and fulfilling use of your time. If you're considering putting yourself or your child in play therapy, you might also want to know what special preparations therapists must go through to become play therapists. Here is a basic rundown of the course of study:

  • The first step is getting a Master's degree or higher in a mental health field.
  • Next, they need to get a mental health license or certification for clinical practice.
  • They need psychology classes that focus on the use of play in the therapeutic process. Currently, to become a registered play therapist, they need to have at least 150 clock hours of instruction in this discipline.
  • They need relevant experience, including supervised play therapy training and clinical hours.
  • They must meet all the criteria and be registered with the Association for Play Therapy.
  • They must achieve play therapy certification in their state.
  • They must conform to the standards and code of conduct of the play therapy association for their state.

The Role of Parents

If the play therapy client is a child, the parents can be an important part of the process. The first step is realizing that the child needs help. If you're wondering if your child does have issues or problems they need to resolve but seems unable to manage them alone, talking to a therapist on your own can help you make that decision. It can also help you improve your own mental health, so you are better equipped to help your child. Fortunately, convenient and inexpensive individual, child, and family therapy is available online through Better Help. It only takes a moment to get started, but the results can last a lifetime.

Below are some commonly asked questions on this topic:

How does play therapy work with children?

Play therapy uses child play to improve a child’s ability to communicate and express their emotions, solve problems, deepen emotional bonds with family, and turn negative behaviors into more positive, appropriate interactions. By forming a therapeutic relationship through play (such as using stuffed animals, puppets, creating scenes in a sand tray, playing therapeutic board games, etc.) mental health and wellness professionals can gain a better understanding of a child’s thought process from the very first therapy session. This knowledge, in turn, will help them focus on the areas they need most help with, such as communication, social skills, problems with life stressors such as parental conflict or divorce, trauma, natural disasters, and more.

What are the four stages of play therapy?

Not every play therapist follows a specific road map to treat children since therapy usually needs to be adapted to every child’s process, unique circumstances, and their own problems. But to gain a better understanding of how play therapy works, it is easier to break down the process in four phases or stages, which are the same for individual and group therapy:

  1. Exploratory Phase: During this stage, which usually begins at the first appointment and continues over the following four or five sessions, the therapist will spend time building a relationship with the child so they feel comfortable expressing themselves freely later on. At these appointments, the therapist will talk to the child, show them the toys and games they will be playing with, and allow them to explore the area safely. Once the child understands the process and feels comfortable with the therapist, together they’ll move on to the next phase.
  2. Resistance Phase: Now that the child and therapist have established a trusting relationship, the counselor can start focusing on the child’s behavior or the therapeutic issues that are causing the negative symptoms to occur through different games and play strategies and always with a non-directive approach. This can be met with some resistance or aggression, but it’s part of the child’s process and is typically short-lived.
  3. Growing or Work Phase: This is where the fun begins! At this point, the child is used to the play therapy dynamic and shows up to appointments eager and ready to talk and play with the therapist, who has gotten to know them a lot better and therefore is better equipped to help the child through their problems.
  4. Termination Phase: As play therapy draws to a close, which like in other therapies occurs when the child is demonstrating their new social and communication skills on a regular basis, and the parents and therapist are happy about all the positive outcomes, there will be a gradual tapering off of sessions until the child has officially ‘graduated’ from therapy.

Does play therapy actually work?

There is plenty of scientific evidence that play therapy can help children ages four to 12. In fact, because it is a well-established fact that children learn through play and games, according to Play Therapy International, over 70% of children who are referred to play therapy experience positive changes in behavior.

What is an example of play therapy?

Play therapy sessions are always tailored to a child’s problems and unique circumstances. Typical techniques that therapists use during play therapy include:

  • Tea party play
  • Building blocks or LEGO bricks
  • Board games
  • Coloring and drawing
  • Puppet play
  • Playing with dolls
  • Card games

Does play therapy help with ADHD?

Like all children, kids with ADHD need to feel connected, secure, and safe, and play therapy can help them achieve that. Research suggests that meeting with a play therapist can help the child with ADHD significantly improve their symptoms.

What are the rules of play therapy?

Play therapy can involve many different techniques and styles of play, so there are no concrete “rules” to be referred to for this type of therapy. In general, a play therapy session takes place once a week and lasts between 30 minutes and an hour, according to Healthline Media.

In the play therapy environment, the patient (usually a young boy or girl) will participate in various activities, such as playing with sand, blocks, dolls, or games. Meanwhile, the therapist will observe the patient’s behaviors and may encourage them to act out various situations with toys. They may also lead in the play, or they may allow the child to be free to play as they please.

Play therapy is most commonly used for children rather than adult patients, and because children have limits in using language to express their feelings, a trained therapy can uncover what is going on in their mind and make an assessment based on the way they play. Play is the way that children make sense of what they discover in the world, and watching a child play can help a therapist determine what may be going on and how to respond to it.

Play therapists can also act as teachers and provide guidance to children and their parents. They can help with problems at school, family issues, aggressive behavior, traumatic events like abuse, and more.

If you or a loved one are facing abuse of any kind, the National Domestic Violence Hotline is available at 1-800-799-SAFE (7233).

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