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Play Therapy for Traumatized Children

What is Play Therapy?

Play therapy is one of the many forms of therapy offered for children who are suffering with severe trauma and post-traumatic stress disorder (PTSD). Every child reacts to trauma differently; however, play therapy has been proven to significantly help children talk about or reenact their trauma in an effective, calm way through the use of toys, drawings, video games, and more. Children between the ages of 3-12 are the target range for play therapy, but it can also be used with older children or adults with cognitive impairments.


What Does Successful Play Therapy Look Like?

The outcome of post-traumatic play depends on several factors: (a) the amount of security and freedom a child possesses in order to express inhibited feelings, (b) the degree of control a child perceives, (c) how well cognitively reworking of the event is facilitated, and (d) the child’s satisfaction with the ending of the play.

Sense of security is crucial for children who are constantly fearful and panicked because of their trauma. There are multiple things a provider can do to offer children a sense of security. This includes therapists showing confidence in the child, confidence in themselves, being eager to spend time with the child, and prioritizing consistency and predictability in their relationship with the child. By giving the child a sense of security, it opens the door for a stronger relationship and overall empowerment.

Sense of control is also a pivotal factor for children with trauma. The fantasy aspect in play allows children to change the story so that they are in control of their trauma. It empowers the child to overcome their feelings of distress and helplessness. Children who feel in control over themselves are shown to be better at working through and understanding their trauma, as well as dealing with potentially triggering situations in the future. Control encourages children to be fully themselves and open to learning more about their feelings and how to cope with them.

Freedom of expression is important when it comes to play therapy because other forms of talk therapy may increase the child’s feelings of anxiety or confusion. Play allows children to express their feelings in any way they want, specifically if the child shows avoidance symptoms. Symbolic play can be more effective at reducing children’s traumatic memories compared to a purely verbal approach. For example, a child’s treatment of a stuffed animal may signal a need for additional nurturing. Dumping out toys and making a mess may signal feelings of powerlessness and loss of control. A child who sorts or “fixes” toys may be acting out a desire for stability and order. A child who pretends to sleep may be signaling that they feel overwhelmed.


Are There Risks Associated with Play Therapy?

There is a risk of the child experiencing post-traumatic play. If the circumstances listed above are not met when conducting play therapy, it can cause the child to relive their trauma or only focus on the negative feelings associated with their trauma in further sessions.


What are the Differences Between the Direct Versus Non-Direct Approach?

The direct approach is called release play therapy. The therapist will choose a few toys or objects closely related to the traumatic events in hopes of urging the child to play out their experience. This approach allows the therapist to be in more control of the situation as they jump straight to having the child express what they experienced. The indirect approach is called child-centered play therapy. The core concepts of this approach are embedded in the therapist’s genuineness, positive acceptance, and empathy. This is because this approach’s main focus is on the therapist’s relationship with the child. Child-centered therapy has demonstrated a notable reduction in children’s anxiety and suicidal tendencies.


Local Play Therapy Resources:

Create Wellness- Cloquet, MN: Play Therapy – Create Wellness Center for Child and Adolescent Therapy (createwellnessmn.com)
Three Sixty Therapeutic Services- Duluth, MN: General 4 — ThreeSixty Therapeutic Services (Copy) (threesixtymn.com)
Superior Counseling LLC- Duluth, MN: Play Therapy | Psychotherapy in Duluth, MN | Superior Counseling LLC


Hammers-Crowell, J. (2022). Play As Therapy. Highland Hospital.
Ogawa, Y. (2004). Childhood Trauma and Play Therapy Intervention for Traumatized Children. Journal of Professional Counseling: Practice, Theory, and Research.