Play Therapy

1. Play is a Child's Natural Language

Unlike adults, whose natural medium of communication is verbalization, the natural medium of communication for children is play and activity.

Beyond Words. Children often lack the verbal skills to fully express their emotions and experiences. Play becomes their primary means of communication, allowing them to explore feelings, resolve conflicts, and make sense of their world in a way that feels natural and comfortable. Play therapy recognizes and utilizes this innate ability.

Symbolic Expression. Through play, children use toys and actions to represent their thoughts and feelings symbolically. A doll might stand in for a family member, or a sandcastle could represent a child's sense of security. Understanding this symbolic language is crucial for therapists to connect with children on a deeper level.

A Right to Play. The UN recognizes play as a universal and inalienable right of childhood. It's not just recreation; it's how children learn, grow, and develop. Play therapy honors this right by providing a safe and supportive space for children to express themselves freely.

2. Child-Centered Play Therapy (CCPT) Centers on the Child's World

The therapist’s responsibility is to go to a child’s level and communicate with children through the medium with which they are comfortable.

Following the Child's Lead. CCPT emphasizes the importance of understanding the child's perspective and allowing them to direct the therapeutic process. The therapist creates a non-judgmental environment where the child feels safe to explore their inner world without external pressure or expectations.

Unconditional Positive Regard. A core principle of CCPT is accepting the child for who they are, without conditions or evaluations. This creates a sense of safety and trust, allowing the child to express themselves freely and explore their feelings without fear of judgment.

Innate Capacity for Growth. CCPT is rooted in the belief that children possess an inherent drive towards growth and healing. The therapist's role is to facilitate this process by providing the right conditions, rather than trying to "fix" the child or impose solutions.

3. The Play Therapist's Person is Key

When I am with children, the person I am is much more important than anything I know how to do in my mind.

Genuineness and Empathy. The therapist's authenticity and ability to connect with the child on an emotional level are paramount. Children can sense when an adult is being genuine, and this fosters trust and allows for a deeper therapeutic relationship to develop.

Self-Awareness is Crucial. A play therapist must possess a high degree of self-understanding and self-acceptance. This allows them to be present with the child without projecting their own issues or biases onto the therapeutic process.

Being With, Not Doing To. CCPT is less about applying techniques and more about creating a genuine connection with the child. It's about being present, listening deeply, and understanding the child's unique experience.

4. Therapeutic Limits Provide Safety and Growth

Play is a medium of exchange, and restricting children to verbal expression automatically places a barrier to a therapeutic relationship by imposing limitations that in effect say to children, “You must come up to my level of communication and communicate with words.”

Boundaries are Essential. While CCPT emphasizes freedom and permissiveness, it also recognizes the importance of setting clear and consistent limits. These limits provide a sense of safety and structure, allowing the child to explore their emotions within a defined space.

Purposeful Limits. Limits should be minimal and enforceable, serving to protect the child, the therapist, and the playroom. They should not be arbitrary or based on the therapist's personal preferences.

ACT Model. When setting limits, the therapist should:

• Acknowledge the child's feelings or desires
• Communicate the limit clearly and firmly
• Target acceptable alternatives for expressing those feelings

5. Facilitative Responses Empower Children

The therapist has a well-stocked playroom, and the child has the freedom to play as she chooses or to remain silent.

Reflecting, Not Directing. Instead of asking questions or giving advice, the therapist uses facilitative responses to reflect the child's feelings, actions, and thoughts. This helps the child to become more aware of their own inner world and to develop a sense of self-understanding.

Returning Responsibility. A key aspect of facilitative responding is returning responsibility to the child. Instead of solving problems or making decisions for them, the therapist empowers the child to find their own solutions and make their own choices.

Examples of facilitative responses:

• "You're feeling angry about that."
• "You're trying to figure out how that works."
• "You can decide what you want to do next."

6. Cultural Responsiveness Enhances Therapeutic Effectiveness

The greatest respect the CCPT therapist can show the person of a child and the child’s culture is to focus fully on the person the child is and Be With the child as completely as the therapist is capable in the moment.

Beyond Generalizations. While understanding cultural norms is helpful, it's crucial to recognize that each child is a unique individual shaped by their own experiences and perspectives. Avoid making assumptions based on cultural stereotypes.

Being With, Not Knowing About. Cultural responsiveness is not about acquiring a checklist of cultural facts, but about being present with the child and creating a space where they feel safe to share their own cultural identity and experiences.

Cultural Humility. Acknowledge the limits of your own cultural knowledge and be open to learning from the child and their family. Be aware of your own biases and how they might impact the therapeutic relationship.

7. Parents as Partners Amplify Healing

If what the therapist does with children in the playroom is helpful to children, those same behaviors exhibited by parents can be helpful to children’s overall growth and development.

Extending Therapy Beyond the Playroom. Involving parents in the therapeutic process can significantly enhance the effectiveness of CCPT. Parents can learn basic CCPT skills to create a more supportive and understanding home environment.

Child-Parent Relationship Therapy (CPRT). CPRT is a structured, 10-session program that trains parents in CCPT principles and techniques. Parents learn to conduct special playtimes with their children, fostering a stronger bond and promoting emotional growth.

Benefits of CPRT:

• Improved parent-child relationship
• Reduced parental stress
• Increased child self-esteem
• Decreased behavioral problems

8. The Playroom: A World of Possibilities

The playroom should have an atmosphere of its own that conveys warmth and a clear message: “This is a place for children.”

Creating a Safe Space. The playroom should be a welcoming and inviting environment where children feel safe to express themselves freely. It should be free from distractions and designed to promote exploration and creativity.

Essential Toys and Materials. A well-stocked playroom should include a variety of toys and materials that facilitate different types of expression:

• Real-life toys (dolls, dollhouse, cars, etc.)
• Acting-out/aggressive-release toys (Bobo, toy soldiers, etc.)
• Creative expression toys (sand, water, paints, clay, blocks, etc.)

Organization and Maintenance. The playroom should be kept organized and clean to provide a sense of order and stability. Broken or incomplete toys should be removed to avoid frustration.

9. Trust the Process: Stages of Therapeutic Change

The play therapy process is a relationship in which the play therapist and a child build and develop their relationship.

A Journey, Not a Destination. Play therapy is a process of growth and discovery, not a quick fix. The therapist must be patient and trust that the child will move at their own pace.

Common Stages of Change:

1. Initial exploration and curiosity
2. Increased expression of emotions, including anger and aggression
3. Development of a stronger relationship with the therapist
4. Increased self-awareness and self-acceptance
5. Integration of new coping skills and behaviors

Reading Themes. As the therapeutic process unfolds, certain themes may emerge in the child's play. These themes can provide valuable insights into the child's inner world and the issues they are working through.

10. Short-Term and Intensive CCPT Offer Flexibility

Children are quite capable of appropriately directing their own growth, and they are granted freedom in the play therapy relationship to be themselves in the process of playing out feelings and experiences.

Meeting Individual Needs. CCPT can be adapted to fit the specific needs of each child. Short-term interventions may be appropriate for children with specific behavioral problems or those experiencing situational stress.

Intensive Scheduling. For children who have experienced trauma or are in crisis, intensive scheduling (multiple sessions per week) can provide more immediate support and accelerate the healing process.

Research Support. Studies have shown that both short-term and intensive CCPT can be effective in treating a variety of childhood issues, including anxiety, depression, aggression, and trauma.

Last updated: April 1, 2025