Why clinicians use play in therapy with children

This is based on my first blog article, written eight years ago. Though the content of that article is still relevant, it could do with a little updating. I hope you like it.

In response to the statement that he or she (the clinician) ‘just plays with the children’ I give you the following reasons why play is important.


Therapy is more likely to be beneficial when children are willing participants. Many children are reluctant, at-least initially, to attend and be involved in therapy. Either they don’t know what to expect, which causes anxiety, or they think that they have to attend because they have been “bad”. However, almost all children enjoy playing and engaging in fun activities with a lively adult. So, incorporating fun activities into therapy is a good way to help children feel relaxed about attending therapy and, indeed, increases their motivation to attend.


Making and maintaining a connection

Research has shown that the heart rates of mothers and infants parallel each other during play[1]. Heart rate is a sign of the level of activity of the nervous system, which is commonly referred to as arousal. Arousal is the physiological component of emotion. When we experience emotion, arousal changes. So, when the heart rates of mothers and infants mirror each other during play, it is possible to conclude that the adult and child are emotionally-connected to each other.


Emotional-connection, as occurs during play, offers a safe environment for the exploration and expression of a range of emotions and, ultimately, a broad and rich emotional repertoire.

Perhaps, most important of all, emotional connection offers experiences of being heard and acknowledged at an emotional level. Feeling heard and acknowledged in this way offers a powerful form of validation that serves as a ‘psychological innoculation’ against mood disorders and other adverse psychological consequences of invalidation (i.e. the experience of not being heard and understood by others) in adulthood.

Emotional connection and, by extension, play, supports emotional health.

Encouraging self-regulation

Most children who are referred for therapy have trouble controlling their emotions, their behaviour, or both. Emotional-connection, as occurs during play, supports the development of emotional awareness (self and other), which is a precursor for empathy and socio-emotional reciprocity (that is, regulating ones own emotions and behaviours in order to achieve mutually desirable outcomes when interacting with another person). Further, emotional-connectedness, as occurs during play, supports opportunities for co-regulation, whereby the adult assists the child to regulate their emotions. Co-regulation is influential in the development of self-regulation.

In sum, play offers opportunities for supporting emotional awareness, emotional self-regulation, and empathy.

Affirmative Experiences

Children who are referred for therapy hold beliefs about themselves, about others and about the world in which they live. Often, one or more of these areas of belief is negative. That is, they might see themselves as bad and helpless, others as mean and uncaring, and/or the world as a harsh place. Simply telling children that they are good, that others are caring and understanding, and that the world is a safe place is rarely effective in changing children’s beliefs. Rather, they need to experience themselves, others and their social world differently. During therapeutic play, children experience themselves as likeable and capable, experience others as fun and “nice”, and their world as safe and a source of happy experiences. This facilitates trust in others and the perception that therapy is a safe place for conversation about the reasons for their emotional distress and/or behaviours of concern.                                                                                                

mum and child playing

Play is an important and natural approach for promoting the emotional wellbeing and positive adjustment of children and young people.

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[1] Reite, M., & Field, T (1985). The psychobiology of attachment and separation. Orlando: Academic Press

About colbypearce

I am a practising Clinical Psychologist with twenty-seven years’ experience working with children and young people recovering from abuse and neglect. I am also an author and educator in trauma-informed, therapeutic caregiving. My programs are implemented in Australia and Ireland, and I am well-known for my practical and accessible guidance for caregivers and professionals alike.
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