If you are wondering whether your child needs help, you have probably already noticed something. Maybe bedtime has turned into a battle, or the meltdowns after school are getting bigger. Maybe your child has gone quiet since a move, a divorce or a loss. And when you start looking for support, the words “play therapy” keep coming up.
It is a fair question to ask before you book anything: is play therapy actually right for my child? Here is how I think about it with parents in my practice, and what the research can and can’t tell us.
What play therapy is, in plain words
Most young children can’t sit on a couch and explain what is bothering them. They don’t have the words yet. What they do have is play. In play therapy, toys, art materials, puppets, a sand tray and games become the way a child shows what they are feeling and practices new ways of coping.
The Association for Play Therapy, quoting the play therapist Garry Landreth, puts it simply: “toys are like the child’s words and play is the child’s language.” The American Academy of Child and Adolescent Psychiatry describes play therapy as using “toys, blocks, dolls, puppets, drawings, and games to help the child recognize, identify, and verbalize feelings” (AACAP, 2019).
In my playroom, that looks like a real room full of real things to play with. The play is not random, though. I am watching, reflecting and responding with a purpose. You can read more about how I work on my play therapy page.
Which children does play therapy tend to suit?
The Association for Play Therapy says play therapy is “especially appropriate for children ages three through 12 years old” (APT). That matches what I see. Children in that range usually settle into the playroom quickly, because play is already how they make sense of the world.
There is a little more nuance by age. A large 2015 research review of child-centered play therapy found stronger average effects for children aged 7 and younger than for children 8 and older (Lin & Bratton, 2015). That doesn’t mean older children don’t benefit. It does mean that for a 10- to 12-year-old, I often weave in more talking and skill-building alongside play. And teenagers usually prefer to talk, so with them I use approaches like CBT and mindfulness instead.
What kinds of concerns does it help with?
According to the Association for Play Therapy, play therapy is used with children facing things like “anger management, grief and loss, divorce and abandonment, and crisis and trauma,” as well as anxiety, depression, ADHD, autism, and social and academic struggles (APT).
In everyday language, parents often come to me because their child is:
- Worried a lot, clingy, or struggling to separate
- Having big outbursts, or hitting and biting more than other children their age
- Going through a family change such as a divorce, a new sibling, or a move
- Grieving a person or a pet
- Having a hard time after something frightening happened
- Pulling away from friends, or seeming sad or flat
- Having trouble at school that seems to be about feelings more than learning
If your family is in the middle of a big change, my page on life transitions, moves and grief may also be helpful.
Signs play therapy may be a good fit
Every child is different, so treat this as a starting point, not a test. Play therapy may be worth considering if:
- Your child is roughly 3 to 12 years old.
- The trouble has lasted more than a few weeks, or keeps coming back.
- It is getting in the way at home, at school or with friends.
- Your child can’t (or won’t) tell you what’s wrong, but their behavior is telling you something.
- You’ve tried the usual things, like more routine, more one-on-one time and calm consequences, and you still feel stuck.
You don’t need to wait for a crisis before reaching out.
When another approach may fit better
Play therapy is a good match for many children, but it is not the answer to everything. Being honest about that is part of my job. A few examples:
Attention and hyperactivity. For children under 6 with ADHD, the CDC recommends “parent training in behavior management as the first line of treatment, before medication is tried” (CDC). If attention is the main concern, I’ll talk with you about whether a parent-focused behavior program makes more sense first, or alongside other support.
Serious behavior problems. When the main struggle is defiance and conflict between parent and child, approaches that coach the parent directly, such as Parent-Child Interaction Therapy, may be the better starting point (AACAP, 2019).
Trauma. Play therapy can help children after hard experiences. For children with clear post-traumatic stress symptoms, it’s also worth knowing that trauma-focused CBT is a widely used treatment for ages 3 to 18 that includes caregivers in parallel sessions (NCTSN). We can talk about what fits your child best.
Medical or developmental questions. If you’re concerned about speech, development, sleep or anything physical, please talk to your pediatrician too. Sometimes a change in behavior has a medical piece, and I’d always want that looked at.
Safety. If your child talks about wanting to die or hurt themselves, or you’re worried about their safety right now, don’t wait for a therapy appointment. In an emergency call 911. You can also call or text 988, or call the Washington County Crisis Line at 503-291-9111.
If, after we talk, I think a different kind of help would serve your child better, I’ll tell you and help you find it.
What can you expect if you start?
I start by meeting with you on your own, without your child. This is your time to tell me your child’s story: their history, what’s been happening, what you’ve tried, and what worries you most. It also means your child’s first visit can be relaxed and playful, rather than a conversation about their problems in front of them.
After that, your child comes to the playroom regularly. The Association for Play Therapy notes that sessions usually last about 30 to 50 minutes and are usually weekly (APT). Early sessions are often about your child getting comfortable with me and the room. Change tends to be gradual, and it is common for things to look a little bumpy before they settle.
Play therapy works best in person, because the playroom itself is part of the work.
How are parents involved?
You are not dropping your child off and waiting outside for months. Research backs this up: the Association for Play Therapy notes that play therapy “works best when a parent, family member, or caretaker is actively involved” (APT). In the 2015 review mentioned above, studies with fuller caregiver involvement showed larger average effects than those with minimal involvement (Lin & Bratton, 2015).
In practice, that means:
- I keep you informed about the themes I’m seeing and how things are progressing.
- We meet regularly as parents and therapist, so you’re part of the plan.
- I share practical ideas you can use at home, so the progress in the playroom has a chance to carry over.
At the same time, your child needs the playroom to feel like their space. I’ll share themes and progress with you rather than a word-for-word account of every session, and I’ll always tell you if something needs your attention.
Still not sure? A few quick questions
Is my child too old for play therapy? Children up to about 12 often still do well with play, sometimes mixed with talking. For teens, I usually use talk-based approaches. You can see more on my child and teen therapy page.
Will my child know why they’re coming? I’ll help you find simple, honest words to explain it, something like “a place to play and talk about feelings.”
Do I need a diagnosis first? No. Many children I see don’t have one. We start with what you’re noticing.
Talk it through with me
You don’t have to decide on your own whether play therapy is right for your child. I offer a free phone consultation where you can tell me what’s been going on, ask your questions, and get an honest sense of whether my playroom is a good fit, or whether something else might help more. Call me at 503-495-5072, or send a message through my contact page. My office is in King City, a few minutes from central Tigard.
Sources
- Association for Play Therapy. “Why Play Therapy?” https://www.a4pt.org/page/WhyPlayTherapy
- Association for Play Therapy. “Play Therapy Makes a Difference.” https://www.a4pt.org/page/PTMakesADifference
- American Academy of Child and Adolescent Psychiatry. “Psychotherapy for Children and Adolescents: Different Types.” Facts for Families No. 86, updated April 2019. https://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide/Psychotherapies-For-Children-And-Adolescents-086.aspx
- Lin, Y.-W., & Bratton, S. C. (2015). A meta-analytic review of child-centered play therapy approaches. Journal of Counseling & Development, 93(1), 45–58. https://doi.org/10.1002/j.1556-6676.2015.00180.x
- Centers for Disease Control and Prevention. “Treatment of ADHD.” https://www.cdc.gov/adhd/treatment/index.html
- National Child Traumatic Stress Network. “Trauma-Focused Cognitive Behavioral Therapy.” https://www.nctsn.org/interventions/trauma-focused-cognitive-behavioral-therapy