How Relational Play Therapy Heals Children

What's relational play therapy? Is that like playing with dollhouses?

There are actually many different types of play therapy. In most forms of play therapy, the child is a sort of "director" of the session, showing the adults what's really going on for her emotionally through "playing it out." The idea is that the child uses symbolic play, such as a dollhouse or dress-up, to express feelings that might be too difficult to put into words. 

Relational play therapies, such as Theraplay®, are very different from traditional play therapy. In Theraplay, there are very few toys and no need for symbolism. Theraplay games are based on the fun little interactions that adults and infants typically have, such as peek-a-boo, which are the "brain food" of healthy development, attachment, impulse control, attention and empathy, amongst other good things. In Theraplay, the child is not the director of the session; the adults are always in charge and provide a lot of structure and direction for the child. This helps children learn to follow the lead of adults, to feel safe in relationships, and to relinquish control in ways that are healthy and anxiety-reducing.

Peek-a-boo? Isn't Theraplay just for babies then?

The short answer is no. Theraplay works with the social/emotional age of the child. Just because someone is chronologically 16 years old, doesn't mean that parts of them still feel, think and behave much younger. This is especially true for kids who have experienced trauma (such as abuse, neglect, invasive medical procedures) or have a sensory integration disorder or Autism. With trauma, the child's brain and body spend so much time in "survival mode" that developmental milestones, emotional regulation and social skills can suffer. Similarly, if you think about a child with sensory defensiveness, their body is constantly interpreting neutral sensory information as threatening or painful. It is very hard to learn when your body is in a state of fear all the time. Theraplay creates space for a child's "youngest self" to feel safe, lovable, connected, and strong. Through this process, the "youngest parts" of the child begin to grow up. 

How would I know if Theraplay is right for my child (or client)?

Theraplay can be helpful for almost any concern that would bring a child to therapy. Because it is a non-verbal form of therapy, it is especially useful for children who are preverbal, cannot remember or verbally express their trauma, or are very resistant to therapy. Theraplay can be an extremely helpful intervention for defiant, spirited children and very withdrawn, shy children. I have found that it is great for "treatment resistant" conditions such as attachment disorders, adoption issues and complex trauma, because it works on creating felt safety, starting from ground zero. Often these kids cannot benefit from other forms of therapy because they don't know how to feel safe in a relationship- not even with their loving parents or a very warm, competent and skilled therapist. Using Theraplay, even in a time-limited way, can create enough felt safety for other methods of therapy to be suddenly be effective. Theraplay is also effective for helping children with sensory integration issues or Autism, because it is a sensory, touch-based model that is led by the adult. This helps kids expand their comfort with new sensory experiences and learn that following the adult's lead with flexibility can feel safe and fun.

Is Theraplay evidence-based? How long has it been around? 

Theraplay was developed in the 1950s in Chicago's HeadStart programs, and it was designed to help preschoolers who were either very withdrawn or very aggressive. Theraplay has since been studied in many populations, including children who have selective mutism, adoption issues, and autism, and it is practiced in at least 44 countries worldwide. Theraplay is currently rated a 3- "promising research" by the California Evidence-Based Clearinghouse for Child Welfare. The Clearinghouse basically sets the bar for which therapies are considered "evidence-based." So the short answer is yes, Theraplay is very evidence-based. You can check that out for yourself here.

Learn more about Theraplay by watching the 10-minute video below or visiting

*A registered service mark of The Theraplay® Institute, Evanston, IL, USA