When I was asked to write an article about play therapy, I didn’t really know where to start. In my years of parenting a kiddo on the autism spectrum, I’ve heard the term used widely to describe many different types of “play” within child psychotherapy: Activity-based versus child-centered (or child-led) models, direct versus indirect styles. There is an approach called Sandplay that incorporates a tray of sand into the session, and there’s an existential model called Gestalt play therapy that I can’t even begin to sum up in a few words, but it sounds pretty much like what I do with my own therapist – I just didn’t know it had a name. In short, when I began my research, I was a little skeptical about what felt like a mighty generous use of the word “therapy” in the title of such a mixed bag.
Now, I’m not one of those people dismissing play therapy simply because there isn’t a thick pile of published research supporting it. In the prime and limited years of early intervention, I cannot afford the luxury of being so narrow-minded. It’s also not that I don’t believe in psychotherapy itself, as my therapist has helped steer me through a few bumps in my life. But really, there’s just no way a six-year-old is getting the same benefit from psychotherapy that I am. Right?
Well, it turns out that I’m a little right, and I’m a little wrong.
Obviously our kids’ brains are not as cognitively developed as ours, so they will not benefit in the same way. But that’s not to say they won’t benefit at all. The whole premise behind play therapy is that, true, children can’t simply discuss or sometimes even identify what’s wrong, what’s making them sad, overwhelmed, depressed or angry. But communication with a child can be had, analyzed, and interpreted through the act of playing. And the ever-important trusting relationship with one’s therapist can be developed through the act of playing together.
Once I was able to understand this overarching principle – the “What it is” – I dug in, and indeed I found some evidence-based medical research backing play therapy. Much of it did not feature children with autism, per say; it featured kids with aggression, or separation anxiety, or obsessive-compulsiveness, or traumatic stress, or a speech delay… Any of those symptoms sound familiar to you? Hell, yes!
Here are a few nuggets of gold I was able to carve out of the bulk of published articles:
- One meta-analysis of 93 separate studies boiled the treatment effect of play therapy down to “0.80 standard deviations,” which in layman’s speak is impressive. This analysis revealed the truth in what many have argued over the years, that direct parent involvement in the therapy does indeed produce the largest effects. (1)
- Play therapy has been proven equally effective across the variables of age, gender, and “presenting issue”, i.e. what first prompted the seeking out of therapy. (2) This shoots another bullet into the theory that intervention has diminishing benefits as our kids age, as it’s in line with news from the neuroscience community that our brains are pliable even going into adulthood.
- Child-centered play therapy, in particular, has proven to be effective in children as young as, not just six, but three years of age. A pilot study conducted on 54 Head Start preschoolers in 2013 found it significantly reducing disruptive behaviors in these young kiddo. (3)
My take-away from this exercise is this: If we say that play therapy for children can be just as useful as psychotherapy can be for adults, then individually the factors that make it most useful are probably comparable for all. To me, those would be A) How much mutual respect and trust do I have with my therapist, and B) How well does that therapist’s approach suit my personality?
So, reader, stealing a line from my shrink… How does that make you feel?